Senator Chuck Grassley (R-Iowa), a senior member and former chairman of the Senate Finance Committee, has joined a bipartisan group of senators to introduce legislation aimed at increasing oversight of pharmacy benefit managers (PBMs) and reducing prescription drug costs. The bill, known as the PBM Price Transparency and Accountability Act, is cosponsored by Finance Chairman Mike Crapo (R-Idaho), Ranking Member Ron Wyden (D-Ore.), and 18 other senators.
Grassley explained his motivation for supporting the legislation: “Iowans at my 99 county meetings are fed up with the high cost of prescription drugs, and for good reason. PBMs are driving local pharmacies in Iowa out of business and making it harder for Iowans to access the medications they need. That’s why I’m introducing legislation with my colleagues to put patients over pharmacy benefit managers by shining a light on the complex and opaque tactics these middlemen use. This landmark bill builds on the bipartisan legislation I spearheaded during my time as Finance Chairman, and includes several proposals I helped craft.”
Key provisions led by Grassley in the bill include increased reporting requirements for PBMs to Medicare Part D plan sponsors and the Department of Health and Human Services, mandatory participation in the National Average Drug Acquisition Cost survey for retail community pharmacies, and a ban on PBM spread pricing in Medicaid. Many of these measures were previously part of the Prescription Drug Pricing Reduction Act, which Grassley advanced through committee in 2019. That earlier initiative sought to save seniors and Americans with disabilities $95 billion in out-of-pocket Medicare Part D costs while reducing premiums by $1 billion.
Grassley played a significant role in establishing Medicare Part D in 2003 when he chaired the Senate Finance Committee, creating an outpatient prescription drug benefit for seniors.
The new bill has support from additional senators including Thom Tillis (R-N.C.), Roger Marshall (R-Kan.), Bill Cassidy (R-La.), Peter Welch (D-Vt.), Marsha Blackburn (R-Tenn.), Steve Daines (R-Mont.), Ben Ray Luján (D-N.M.), John Cornyn (R-Texas), James Lankford (R-Okla.), Mark Warner (D-Va.), Maggie Hassan (D-N.H.), Catherine Cortez Masto (D-Nev.), John Thune (R-S.D.), John Barrasso (R-Wyo.), Tina Smith (D-Minn.), Michael Bennet (D-Colo.), Raphael Warnock (D-Ga.) and Sheldon Whitehouse (D-R.I.).
Grassley has consistently worked on lowering prescription drug prices through various legislative efforts. In May 2025, he chaired a Senate Judiciary Committee hearing where witnesses supported his push for greater transparency among PBMs. Earlier this year, six bipartisan bills backed by Grassley passed through committee to increase competition in pharmaceuticals. He also reintroduced two bills focused on price reduction and accountability: the Prescription Pricing for the People Act and the PBM Transparency Act.
Grassley has urged action from both Congress and federal agencies such as the Federal Trade Commission regarding PBM practices since at least January 2024. He has sent letters encouraging investigations into industry middlemen’s roles in drug pricing, welcomed FTC reports on PBMs, and advocated for stronger oversight provisions within congressional committees.
Over recent years, several provisions authored or coauthored by Grassley have become law with aims to address anticompetitive practices among pharmaceutical companies.
