Many prices are on the rise going into 2024, including prescription drugs, which are expected to skyrocket in the first few weeks of the new year. Meanwhile, inflation and cost of living increases are still hitting Utah’s families with full force. As a small business owner planning my operations for the new year, these concerns are top of mind for the people I employ as I navigate another year of setting them up for success. Part of this process requires finalizing benefits for my staff, and last year’s discussions on health care in Washington have me worried about my ability to continue offering affordable health coverage.

Many of these discussions singled out pharmacy benefit companies as the alleged driver behind rising drug prices. Buzzwords like “middlemen” and “delinking” were used to make the case for reforms, but as a business owner, it seems like none of us were asked if either of the proposals being considered in Congress will actually help save prescription drug costs for our employees. In fact, they will only pile on the already sky-high expenses our business is facing.

We choose to work with pharmacy benefit companies to help lower the cost of prescription medications for our staff. “Choice” should be a keyword for legislators, as the options provided by pharmacy benefit companies help save roughly $800 per enrollee every year. Choice also allows employers like me to work with pharmacy benefit companies to craft and implement the best plan for my unique business operations.

“Delinking” policies would do the exact opposite, as they would disconnect the incentives pharmacy benefit companies receive for securing higher rebates and cripple the ability of pharmacy benefit managers to provide affordable options for employers. Additionally, the policy would raise costs in the commercial health insurance market by $26.6 billion per year. Not only will pharmacy benefit companies no longer be able to provide the same quality and affordable pharmacy benefits, but the cost to patients and payers will be even higher with this legislation.

These big-government tactics to smother the free market are nothing new. Sen. Mitt Romney fought against spread-pricing elimination for pharmacy benefit companies with his amendment to S. 1339, the Pharmacy Benefit Manager Reform Act. “Delinking” pharmacy benefits from rebates is no different. It is a misguided attempt to “fix” the health care system without considering the impact it will have on Americans.

Former Sen. Pat Toomey came to a similar conclusion about the newest “delinking” legislation, writing:

“The proposals targeting PBMs aim to eliminate PBMs’ ability to earn a percentage of the savings they negotiate and/or force PBMs to disclose negotiated prices in business-to-business transactions. These measures would reduce PBMs’ capacity to generate savings in future negotiations. … Specifically, members are proposing to restrict how pharmacy benefit managers (PBMs) negotiate savings for their clients and get compensated for their work.”

Other small business owners like me have taken notice as well and voiced their support for the choices and flexibility pharmacy benefit companies offer. A survey from last October revealed a vast majority of small business owners value pharmacy benefit companies and the services they provide. By the numbers, 89% of employers indicated that these companies helped them provide affordable benefits, with 91% of employers saying that flexibility and choice in the organizational use of rebate dollars is important.

“Delinking” will explicitly fly in the face of time-tested free market principles and, perhaps more importantly, the voices of small businesses from across the county.

Here in Utah, we need our legislators to stand firm against policies that will make it increasingly difficult for businesses to provide employees with the most affordable, highest-quality health care. We need our legislators to fight against “delinking” and hold the line for Utah’s small businesses.

Jim Ross is a small business owner here in Utah.

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