The leaders in the effort to reduce the cost of prescription drugs in Maryland are expressing alarm that Gov. Lawrence J. Hogan Jr. (R) may be planning to ignore key components of a new state law.
The legislation creating a Prescription Drug Affordability Board passed the General Assembly with solid majorities — including a vote of 46-0 in the state Senate.
The measure took effect on July 1, and legislative leaders and the attorney general recently announced their selections to serve on the five-member board.
But the governor has yet to name his designated appointee to the board. And he has refused to release the $831,900 that the legislature included in this year’s budget to get the panel launched, opting instead to search for existing Department of Health resources.
“I don’t understand why he wouldn’t fund it, when the appointments have been made,” said Del. Joseline Peña-Melnyk (D-Prince George’s and Anne Arundel), chief House architect of the bill. “I’m really surprised, because if he wanted [the board] to be part of the Health Department, why didn’t he testify during the hearings?”
Hogan didn’t sign Peña-Melnyk’s bill, HB 768, but he did allow it to become law without his signature. During his April trip to New Hampshire, when he was contemplating a bid for president, Hogan touted the measure during a Q&A at Saint Anselm College.
Maryland’s push to create a system capable of forcing reductions in medications deemed too expensive — without encountering potential problems with the U.S. Commerce Clause — is being closely watched by other states and the pharmaceutical industry. Drug manufacturers spent more than half a million dollars to lobby against the measure in 2018 and 2019.
The bill creates a process where experts can analyze high-priced drugs to determine whether the consumers and insurance plans are being fleeced.
Several county executives — including one Republican — and a host of religious and community leaders spoke out in favor of the legislation during this year’s session. Several said their health plans were being hit hard by a relatively small number of high-cost medications, including some that had recently spiked in price for no discernible reason.
Peña-Melnyk said lawmakers took pains to give the Prescription Drug Affordability Board the independence to pursue its work. The bill calls the panel “an independent unit of State government.”
“The board is supposed to be independent. I know because I helped draft it,” she said. “It is free of the politics and craziness. It’s in the bill. We did it purposely.”
Vincent DeMarco, head of the Maryland Citizens Health Initiative, a chief backer of the bill, is hopeful Hogan intends to use existing Health Department funds to get the drug board on its feet and to allow the executive director to hire staff.
“That would be great,” he said. Staffing the board with existing personnel, however, instead of with its own executive director, “would clearly be bad policy and — I believe — illegal.”
“The statute says very explicitly the board is independent and the board chair ‘shall hire an executive director, general counsel and staff,’” he added. “It can’t be more clear than that.”
Michael Ricci, Hogan’s communications director, was asked if the governor intends to release the fiscal year 2020 funds — and to allow the board to function independently. He suggested that Hogan and the legislature aren’t as far apart as some lawmakers are asserting.
“The governor agrees this is an important endeavor, which is why we are working with our Health Department to stand up the board without the need for new taxpayer funding,” Ricci said in a statement.
The governor and legislature are involved in a standoff over a host of budgetary issues.
But Peña-Melnyk expressed dismay that the governor would skirmish over the legislature’s push to provide cost savings to consumers who take prescription medications.
“It’s a no-brainer,” she said, “because it’s an issue that everyone is concerned about.”
“Not everyone has the health care that the governor has or that I have. Our constituents want this. They want relief,” she added. “I wonder if someone got to him.”