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Delaware pushes for more transparent PBM pricing in state benefits
Delaware says its Group Health Insurance Plan is projected to cost nearly $1.6 billion for fiscal year 2027, and a 2025 resolution aims to expose drug-pricing and rebate details in negotiations.
A Delaware state senator is pressing the committee that manages health benefits for more than 135,000 public employees to move faster on drug-pricing transparency, in a dispute that mirrors new federal disclosure rules for pharmacy benefit managers.
Sen. Ray Seigfried, a Democrat from Claymont and a former ChristianaCare executive, sponsored a 2025 resolution directing Delaware's State Employee Benefits Committee to identify ways to make PBM negotiations more transparent. He argues the state could save tens of millions of dollars by addressing hidden costs in the health care supply chain, and wants plan administrators to be able to access pricing data and negotiate accordingly.
The Delaware Group Health Insurance Plan covers state employees, educators, law enforcement officers, retirees and their families, and was projected to cost nearly $1.6 billion for fiscal year 2027, according to a budget presentation. WHYY News reports the SEBC response said ideas from the resolution have been incorporated into its current bid process for a new PBM, but warned that broader transparency could raise prices or jeopardize existing rebates.
According to the outlet, SEBC chair Surgeon General Neil Hockstein said the report highlights limitations in the current PBM marketplace, including proprietary systems and confidentiality provisions that restrict disclosure of certain pricing information. The federal backdrop is the Consolidated Appropriations Act of 2026, passed February 3, which requires large self-funded employer plans to receive detailed semiannual drug-pricing and rebate reports and a 100% rebate pass-through, though large fully insured plans must opt in each year.