Interesting fact check from Freedom Virginia:
Fact Check: Governor Spanberger’s Veto Statement and the Misinformation Around the Affordable Medicine Act
RICHMOND, Va. — On Tuesday, Governor Abigail Spanberger vetoed the Affordable Medicine Act that would have lowered the cost of medicine for hundreds of thousands of Virginians. After breaking down the misinformation behind Pharma-funded former Governor Glenn Youngkin’s veto of similar legislation last year, let’s break down Governor Spanberger’s veto statement and the general misinformation swirling around the Affordable Medicine Act.
MISINFORMATION EXHIBIT A: “Evidence from other states clearly shows that Prescription Drug Affordability Boards (“PDABs”) do not achieve this goal. They are expensive undertakings that other states have either repealed or are considering repealing due to costs and ineffectiveness…”
Fact-Check: FALSE
First and foremost, the bill – which began the 2026 session with language establishing a PDAB framework – changed during the session based on stakeholder input to no longer include a PDAB provision and instead directed the state’s Department of Health to extend Medicare’s negotiated Maximum Fair Prices to Virginians on certain state-regulated health plans:
“C. No manufacturer or wholesale distributor permitted pursuant to this chapter shall accept payment at an amount higher than the maximum fair price for the sale of a referenced drug intended for use by individuals in the Commonwealth in person, by mail, or by any other means, plus any applicable pharmacy dispensing fees and provider administration fees.”
Since the U.S. Supreme Court gave states the authority to set healthcare payment rates in 2020, states including Colorado, Minnesota, and Maryland have moved to use this power to lower costs for consumers. The Boards’ mixed success to date has been largely due to opponents, including pharmaceutical companies, slowing down implementation, not due to actual legal or policy challenges. After the Maryland Board passed, it didn’t receive any funding due to former Gov. Larry Hogan’s opposition, which coincided with his receiving significant contributions from drug companies. Under the current Governor, Wes Moore, the board has not only been funded but has also set multiple Upper Payment Limits (UPLs), most recently on Ozempic, projected to save state and local governments nearly $6 million annually. In Colorado, the Board faced premature lawsuits from pharmaceutical companies that have now been dismissed, and it has successfully set a UPL for Enbrel, which takes effect on January 1, 2027 and will cut consumer costs by more than 40%. They have also reviewed other drugs and opted not to set a UPL after considering both consumers’ and pharmaceutical companies’ arguments, proving that the Board is working how it’s supposed to. One state that has repealed its PDAB, New Hampshire, did so because it lacked rate-setting authority and was not lowering any patient costs as a solely advisory body.
The approach of Virginia’s Affordable Medicine Act would be a first-in-the-nation policy that takes what has worked from both state PDABs and the federal Inflation Reduction Act and learns from what hasn’t worked. The bill’s novel approach to streamline implementation by replicating the work done by Medicare to negotiate Maximum Fair Prices, rather than standing up a new state regulatory entity, recognizes that the path forward for states to lower prescription drug costs is not by disbanding the concept of setting payment rates, but by replicating a successful federal program implemented by both the Biden and Trump administrations to lower costs automatically for 45+ drugs rather than a cumbersome drug-by-drug review process. The Minnesota Department of Health last month underscored the effectiveness of the Affordable Medicine Act’s design by releasing data estimating Minnesotans could save $100 million annually in reduced out-of-pocket costs and premiums if they implemented the Virginia model and extended Medicare’s MFPs. Legal precedent also continues to grow, with the Supreme Court this month rejecting Big Pharma’s appeals challenging the Medicare negotiated drug prices. As the Supreme Court noted, every single federal lawsuit filed against the Medicare Maximum Fair Prices has failed.
MISINFORMATION EXHIBIT B: “I offered amendments to the General Assembly that would have directed the Prescription Drug Affordability Advisory Panel to study a reference-based pricing system before the state spends millions of dollars on implementation. My amendments also would have required greater drug pricing transparency for consumers and policymakers, providing new data to give insight into drivers of out-of-pocket costs in Virginia…”
Fact-Check: MISLEADING
The bill passed by the General Assembly would have established a Prescription Drug Advisory Panel, which would have had no regulatory power, only advisory power, and served as a data-collecting entity to make policy recommendations and ensure Virginia’s approach was as effective and innovative as possible:
“A. The Panel shall (i) meet quarterly to review prescription drug pricing, cost and utilization trends, and trends in out-of-pocket payments; (ii) analyze drug transparency data; and (iii) report annually pursuant to subsection C of § 32.1-276.12 on topics and information, including:
1. Public and private sector drug price trends;
2. Out-of-pocket costs for patients in the Commonwealth related to prescription drug expenses;
3. Opportunities to enhance transparency in reporting prescription drug prices and any rebates, discounts, or price concessions;
4. Methods for the Department of Medical Assistance Services to best utilize the best price provisions of the Medicaid drug rebate program under 42 C.F.R. § 447.509 to increase savings to the Commonwealth;
5. Strategies for local governments to reduce spending on prescription drugs;
6. Opportunities to improve the Commonwealth’s data collection and reporting systems, including standardized electronic reporting formats; and
7. Suggested statutory or regulatory changes to improve affordability and transparency.”
The Affordable Medicine Act also contained landmark provisions to strengthen transparency on consumer spending and ensure that corporate entities – including pharmacy benefit managers – are not price gouging Virginians:
“B. Each pharmacy benefits manager shall provide to the Panel, upon request, financial information, including administrative fees, formulary management fees, rebate retention, network access fees, shared savings programs, and the total and final payment details, including the ingredient cost and any dispensing fee, paid or payable by the pharmacy benefits manager to a pharmacy for dispensing a referenced drug. Such information shall include all associated fees, adjustments, and reconciliations […].”
This language would have provided the greatest possible transparency for consumers and policymakers, but the Governor’s amendments would have required this language to pass again in the 2027 session to become law, effectively removing it from consideration this year.
MISINFORMATION EXHIBIT C: An often-used argument against the bill is that “the bill would have given money to insurance companies and not back to consumers.”
Fact-Check: FALSE
In recent months, organizations funded by Big Pharma have waged a robust and intentionally misleading ad campaign against the Affordable Medicine Act*. Rather than see any profits reduced to save money for consumers, drug companies have been fighting this bill with falsehoods, claiming that the bill would be a giveaway to insurance companies. On the contrary, the bill specifically and explicitly required insurance companies to direct any savings to consumers:
“E. Each health plan regulated under the laws of the Commonwealth shall inform the Board of how the cost savings related to the maximum fair price pursuant to this section are directed to the benefit of enrollees with a priority on enrollee cost-sharing. Any savings generated by a health plan, state entity, or participating ERISA plan that are attributable to the implementation of the maximum fair price pursuant to this section shall be used to reduce costs to consumers, prioritizing the reduction of out-of-pocket costs for prescription drugs. On or before April 1 of each calendar year, each health plan, state entity, and participating ERISA plan shall submit to the Board a report describing the savings achieved as a result of implementing upper payment limits and how those savings were used to reduce costs to consumers.”
Additionally, the bill would have held drug companies accountable for lowering costs by ensuring manufacturers could not withdraw certain drugs from the Virginia market as a result of the Maximum Fair Price implementation:
“F. No manufacturer subject to the provisions of this section shall remove a withdrawn drug from sale or distribution within the Commonwealth for the purpose of avoiding the impact of the rate limitations set forth in this section […] G. The Commissioner shall assess a penalty on any manufacturer that he determines has withdrawn a referenced drug from sale or distribution in the Commonwealth in violation of subsection F. With respect to each referenced drug withdrawn by such manufacturer, such civil penalty shall be equal to the greater of (i) $100,000 or (ii) the total amount of annual savings for the referenced drug, as determined by the Board pursuant to subsection E.”
*https://www.patientsrising.
org/advocacy-updates/virginia- sb271-veto-patients-rising; https://www.usatoday.com/ story/news/politics/2016/07/ 11/pharma-trade-group-helps- fund-patient-fight-against- medicare-project/86592800/; https://mstr.app/430af005- 30ac-494b-96a1-26d847a48ba7 Freedom Virginia Co-Executive Director Rhena Hicks released the following statement:
“Recent analysis showed that Virginians were projected to save nearly $100M annually on medicine starting January 1, 2027. Because of this veto, hundreds of thousands of Virginians will need to wait at least another year to see substantial savings on prescription drugs. Without these savings, Virginians will continue to struggle as health care costs rise and inflation accelerates. The General Assembly made the decision to act and set Virginia on a path to become a national leader in health care affordability. Alongside stakeholders, they worked hard to put forth a model for effective state policy that would lower costs, increase transparency, and hold corporations accountable. The legislature rightly rejected the governor’s amendments to the bill, which would have effectively vetoed the cost savings and transparency measures and set up an advisory-only system similar to the New Hampshire PDAB, which was repealed for its ineffectiveness in lowering costs. Rather than put her faith behind the General Assembly and its decision, the governor decided to veto the bill. Despite her veto, the Affordable Medicine Act remains an effective and innovative first-in-the-nation policy. The fight to lower the cost of medicine is far from over, and we will not give up a cause that consumers so desperately need.”
