Before we dive in to the particulars of the situation surrounding Senate Bill 99, let's get one thing straight;
SB99 does NOT cost the customer anything and no amount of lying by the Alabama medical mafia is going to change that.
It is often said that truth is the first casualty of war. Make no mistake about it, there is a war being waged against the silent majority in Alabama of humble folks who live by modest means in the rural counties that far and away make up the lion's share of this state. It is an economic war being waged by a plutocratic elitist cabal headquartered in downtown Birmingham who use their ungodly wealth to lord it over the vast majority of the population living out in the country. If you are one of the common people under attack, you may ask, what does the enemy look like?
As you are reading this article, there is a piece of legislation titled Senate Bill 99 which when passed will protect the fragile ecosystem of Alabama's independent pharmacies from being destroyed by predatory Pharmacy Benefits Managers who are shell companies that act as health insurance middlemen that reap astronomical profits through reimbursing small business neighborhood drug stores below their cost for the prescriptions that they fill. This man, Robin Stone, acting as the point man for greedy corporate interests in Alabama through his position as the Executive Director of a medical mafia front group euphemistically named the Alliance of Alabama Healthcare Consumers has made it his life's mission to shield the wicked embezzlement of the state's wealth by PBMs from scrutiny so that they can continue to extract billions of dollars from our state's healthcare system every year without any intervention by lawmakers who would seek to pass this bill and make it law.
Is Robin Stone a depraved liar who will say anything to subvert an effort by lawmakers to halt the destruction of independent pharmacies in Alabama? Yes, he is. It would be bad enough if Mr. Stone was the only threat to the passage of SB99. Unfortunately, there is a more pressing issue right now than Stone's campaign of lies and it is called Senate Bill 93. If this all is starting to seem overly complicated, it is, but that is not an accident. This obscene level of complexity is intended by design to sabotage the grass roots movement that would otherwise put an end to the PBM reign of terror over Alabama's independent pharmacies.
Due to several consecutive years of failure by the Alabama Pharmacy Association (APA) to pass effective legislation that would protect independent pharmacies from the PBM malfeasance that has put scores of them out of business just in the past half decade, a group of brave advocates for rural healthcare have come together in these last few months to form the Alabama Independent Pharmacy Alliance (AIPA). This coalition of community pharmacy owners, pharmacists and staff members have united in the pursuit of seeking legislative remedy from the PBM scourge that threatens the survival of their livelihoods. SB99 is the brilliant end result of their outstanding efforts.
Instead of supporting the newly formed AIPA and their immaculately crafted piece of legislation, the APA has sought to steal their thunder by introducing their own competing SB93 with the same ostensible goal of curbing PBM abuse yet it is an inferior product.
Where's the beef, you ask?
So, even by broken clock standards, yellowhammer gets kudos for batting 1000 here compared to their local media compatriots. With contrasting qualities such as SB93 being a "a milder option" as opposed to SB99 which is a tougher, full-scale alternative with larger senatorial backing it doesn't take a genius to figure out that SB99 is obviously the way to go. Hands down.
Here are some hard facts for comparison;
In a February 11th interview with 1819 News, SB99 sponsor State Sen. Larry Stutts (R-Tuscumbia) laid it all on the line;
Stutts said his PBM legislation has enforcement provisions that allow the Department of Insurance to “enforce the intent and the letter of the law.”
“This legislation is actually going to save consumers money. Because what happens right now is the PBMs direct people to their own pharmacies or mail-order pharmacies, so there’s no free-market principles involved there,” Stutts told 1819 News on Monday. “Where it’s going to save money is the PBMs get a rebate from different drug companies to put their drug on their formulary. So even if there’s a cheaper, generic alternative, you may be forced to use the drug that’s on the formulary which is more expensive. What my bill does is it mandates that the rebate goes back to the consumer instead of going to the PBM. The PBMs call it a rebate. I would call it a kickback. They get reimbursed money after the fact for including a particular company’s drug on their formulary. This is going to save the consumer money because it’s going to give you options of drugs that may not currently be on the formulary of the PBM. My bill mandates that that rebate either go directly back to the customer, who is the patient, or it goes back to the customer, who is the employer that provides them with insurance. Either way it’s going to drive either the insurance rates down or it’s going to go directly back to the consumer. In the long run, it’s going to save the consumer money.”
These words cut right to the heart of the matter in terms of why the AIPA had to be formed to begin with. Working from the same losing playbook year after year, the APA has lost the confidence of not only independent pharmacies but many larger chain pharmacies and key stakeholders as well. Yet, the APA refuses to stand down and stand aside while remaining completely clueless as to why so many pharmacies refuse to follow their lead any longer and are supporting SB99 over their SB93. When the APA was the only game in town they wasted their precious chance to win by not consulting beforehand with the relevant governing body, the Alabama Department of Insurance, to ensure that the legislation they were putting forward had airtight enforceability that blood money fiends like Robin Stone could not find a workaround to circumvent.
Tennessee bossed up and handled PBMs in their state four years ago by passing legislation which was signed into law by their governor to ensure that independent pharmacies were being fairly compensated so that they could stay in business for the everyday folks who depend on them. Still, the APA insists on staying deaf, dumb and blind to the Tennessee success story by refusing to follow their lead and instead pursuing the definition of insanity by doing the same thing over and over again while expecting different results.
Lucy with Charlie Brown's football, anyone?
Independent pharmacies don't have the same luxury as the highly overpaid APA lobbyists who lack a sense of urgency because unlike Bobby Giles and Louise Jones, this is not business as usual. Lives are on the line for independent pharmacies. It is all about skin in the game. Bobby and Louise will still be laughing all the way to the bank when the last independent pharmacy in Alabama has closed its doors and they move on to their next grift.
In last year's 2024 legislative session, the APA sent out a freshman legislator by the name of Philip Rigsby to pass HB238 without any co-sponsors. Despite Rigsby's impeccable character and valiant efforts, such poor planning and execution by the APA honchos effectively rendered it a fool's errand. Nor did the APA consult beforehand with the Department of Insurance regarding the legislation's enforceability. Incompetence at best, sabotage from the inside at worst.
Going forward, smart money will be behind SB99. Let's move forward with legislation crafted by independent pharmacists, vetted by independent pharmacists. That way, we can all focus on who the real enemy is.
Who would take medical advice from this guy? Robin, get you some ointment!
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