Testimony On HB 4990: Texas Pharmaceutical Initiative

The Texas Association of Health Plans is concerned that HB 4990 could create a carve-out of the prescription drug program from Medicaid managed care, returning to a fragmented fee-for-service program. Multiple studies have shown that carving drugs out of managed care in Texas would cost Texas taxpayers hundreds of millions of dollars. Equally important, we are concerned that a carve-out would negatively impact health care outcomes.

Most states “carve in,” or integrate, all Medicaid benefits into managed care. Shifting the administration of Medicaid drug benefits to managed care reduced spending by 21% with no decrease in quality of care. In 2017, prescription drug carve-in programs achieved $7.4B in savings for U.S. taxpayers.

Read the full testimony.

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