Springfield, MO

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Pharmacy: Bill attacks insurance

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To pharmacy manager Whitney Grove, the health care reform bill is more significant for what it didn’t do than for what it did.

Grove, who manages three locations of Springfield-based Grove Pharmacy said the most notable omission is regulations for pharmacy benefit managers, or PBMs, which act as middlemen between pharmaceutical companies and pharmacies by negotiating discounted prices with manufacturers and processing payments.

Grove thinks the recently passed health care reforms started out with good intentions, but the end result didn’t live up to the initial promise.

“Trying to cover the uninsured in the United States and give them more access to coverage, whether it be medical care or access to prescription drugs, is positive,” said Grove. “It ended up being a bill aimed at reshaping health insurance.”

Grove thinks the legislation has some positives, specifically its provisions to fill the so-called “doughnut hole” in Medicare Part D coverage, offering rebates to those in the coverage gap and closing the gap by 2020.

For small pharmacies, those positives are outweighed by measures such as taking pre-existing conditions out of the picture – initially for younger people – which puts pressure on insurers.

“What that squeeze will do is create lower reimbursement for providers and increased premiums for people with coverage already in place,” he said. “People would be foolish to think the insurance companies aren’t going to continue to make money.”[[In-content Ad]]


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