Penn Live: Three under-the-radar healthcare fights this year will impact Pennsylvanians
By Jennifer Riley, Patients Come First Pennsylvania’s Executive Director
As Pennsylvania bigins 2026, several healthcare debates are already commanding significant attention from policymakers and the public alike, including subsidies and affordability, persistent workforce shortages, and rising insurance costs.
Beyond the most visible fights, however, there are other healthcare issues that deserve serious focus next year. They may receive less daily attention, yet they have a profound impact on patients’ day-to-day experiences and healthcare costs across the Commonwealth.
PBM reform & pharmacy closures
Pharmacy benefit managers (PBMs) play a central but often invisible role in the prescription drug supply chain, influencing which medications are covered, where patients can fill prescriptions, and how much pharmacies are reimbursed. Their market power and lack of transparency have been linked to rising costs and a growing number of pharmacy closures.
Pennsylvania has already taken steps to address PBM practices. In recent years, lawmakers passed bipartisan reforms aimed at increasing transparency and curbing some of the most problematic behaviors.
Yet pharmacy closures continue, underscoring that current reforms have not gone far enough. Since early 2020, roughly 1,100 licensed pharmacies have closed in Pennsylvania. As a result, patients lose convenient access to prescriptions, face longer travel times and lose trusted relationships with local pharmacists who often serve as a first line of care.
This year, the debate will move beyond whether PBMs should be regulated to whether existing oversight is sufficient. Lawmakers are increasingly aligned on the need for greater transparency and fair reimbursement standards so that savings reach patients rather than being absorbed by intermediaries. Pharmacy access is no longer a niche issue. It is a core access and affordability issue.
Junk science & legal ads
Another issue quietly reshaping healthcare is the explosion of legal advertising tied to prescription drugs and medical treatments. Pennsylvania sees more than its share of these ads.
From 2017 through 2021, more than 2.1 million legal ads aired on local television across the state, far exceeding national averages and costing over $190 million. Designed to generate lawsuits, these ads are based on cherry-picked or junk science that creates fear that can put patients at risk.
A recent national survey found that two-thirds of Americans believe lawsuit ads make people unnecessarily fearful of medications that are safe when used as prescribed, and only 41 percent trust law firm ads to provide balanced and accurate information. This concern has gained urgency following President Trump’s executive action calling for greater scrutiny of prescription drug advertising. If safeguards are needed to protect patients from misleading drug ads, the same logic should apply to legal advertising that mimics medical guidance without scientific standards or accountability.
This year, state and federal lawmakers have an
opportunity to extend consumer protections to legal advertising, ensuring medical decisions are guided by science and clinicians, not misleading marketing.
340B reform and the pilot program
The 340B Drug Pricing Program plays a significant role in our healthcare system. Established to allow eligible safety net providers to purchase outpatient drugs at deep discounts, the program was intended to help hospitals and clinics stretch scarce resources and expand care for low-income and underserved patients. Over time, however, the program has grown substantially with limited visibility into how savings are used.
Read the full op-ed in Penn Live here.