Poll shows voters sounding the alarm on health insurance companies and PBMs

Many Americans battle with an illness every day, but unfortunately for some, their illness is not the only battle they face. A recent Morning Consult/PhRMA poll of 2,004 registered voters shows that Americans are frustrated by the hurdles imposed by insurance companies and pharmacy benefit managers (PBMs) that can stand between them and their medicines, and they want lawmakers to advance solutions that increase transparency and require insurance companies and PBMs to share rebates or discounts they receive directly with patients to lower out-of-pocket costs at the pharmacy counter.

Here are four key findings from the registered voter survey:

1. The top health care issue for voters is out-of-pocket costs set by insurance companies and PBMs.

• While 49% of voters say inflation is the most important issue heading into the midterm elections, when it comes to health care issues specifically, 32% of voters say out-of-pocket costs not covered by insurance¹, such as deductibles, copays, coinsurance and out-of-network charges are the most important issue.

2. Voters are facing affordability challenges to accessing health care.

• 43% find it difficult to afford high deductibles set by insurance.
• 81% of voters say health insurance companies and middlemen, like PBMs, continue to raise costs for patients — including 86% of Democrats, 76% of Independents and 77% of Republicans.

3. As voters learn more about PBMs and their tactics, their concerns grow.

• 81% of voters are concerned that PBMs and payers receive billions of dollars in rebates and discounts from prescription drug manufacturers, but patients do not always benefit from these savings directly.
• 80% of voters are concerned that negotiating power is increasingly concentrated among fewer PBMs — the top three PBMs now control 80% of the market.
• 79% of voters are concerned when they learn payments from prescription drug manufacturers to payers, middlemen, providers and other stakeholders have tripled between 2012 and 2021.

4. Voters support patient-centered solutions that actually address their concerns – like transparency, predictability and lowering out-of-pocket costs.

• The vast majority of voters favor solutions that hold insurers and PBMs accountable, including:
  • 82% support requiring health insurance companies to be more transparent about which drugs are covered and what patients will pay out of pocket for prescription medicines.
  • 80% support requiring health insurance companies and PBMs to share rebates or discounts they receive directly with patients to lower out-of-pocket costs at the pharmacy counter.

As policymakers consider solutions to address patients’ health care affordability challenges ahead of the 2022 midterm elections, they should listen to voters and prioritize real concerns and challenges Americans say they face. Learn more about how we’re working to improve the health care system at PhRMA.org/BetterWay.

This poll was conducted by Morning Consult, on behalf of PhRMA, between April 27-May 2, 2022 among a sample of 2004 Registered Voters. The interviews were conducted online and the data were weighted to approximate a target sample of Registered Voters based on gender by age, educational attainment, race, marital status, home ownership, race by educational attainment, 2020 presidential vote, and region. Results from the full survey have a margin of error of plus or minus 2 percentage points.

Link to full memo.

^1. “out-of-pocket costs not covered by insurance” refers to all costs that are not reimbursed by insurance.