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On February 3, 2026, Congress passed the FY 2026 funding package for the Department of Health and Human Services, which includes important health care reforms. For years our advocates have been calling for pharmacy benefit manager (PBM) reform to help people with diabetes and other chronic conditions better afford their medications. The Diabetes Leadership Council (DLC) and Diabetes Patient Advocacy Coalition (DPAC) are pleased to see PBM reform included in this package, a critical first step in addressing the role these middlemen play in driving up prescription drug prices. We thank our advocates and the entire patient advocacy community for their tireless work in raising awareness and pushing Congress to act.
The PBM reforms passed include important provisions like requiring PBMs to pass rebates and discounts through to plans, increasing transparency and oversight reporting requirements, and expanding pharmacy access by requiring Medicare Part D plan sponsors to contract with any willing pharmacy. However, these changes alone will not directly lower what patients pay out of pocket at the pharmacy counter.
“Our work is not done and our advocacy continues,” said George Huntley, CEO of DLC and DPAC. “The reforms take important steps to improve transparency and expand pharmacy access, but they stop short of lowering costs for patients.”
We also welcome several additional provisions in the appropriations package that DLC and DPAC have long supported alongside our partners in the diabetes community:
· Expanded virtual access within the Medicare Diabetes Prevention Program (MDPP) and removal of the once-per lifetime individual enrollment limit. MDPP is an evidence-based behavior change intervention to delay or prevent the onset of type 2 diabetes among people with Medicare.
· Extension of the Special Diabetes Program (SDP) for Type 1 diabetes research through Dec. 31, 2026.
· Increased funding for diabetes research through SDP and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
· Extension of Medicare telehealth flexibilities through Dec. 31, 2027, sustaining virtual care delivery.
While these provisions make positive strides for the diabetes community, we are still gravely concerned that failure to extend Affordable Care Act enhanced advance premium tax credits, combined with last year’s Medicaid cuts, will leave many in the diabetes and patient community without access to affordable health insurance. We urge Congress to act to protect access to coverage and care and prevent serious harm to people living with diabetes.
