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HR6610 would mandate NADAC-based reimbursement and point-of-sale rebate passthrough for PBMs in federal employee health plans. The bill is early-stage with 32 cosponsors and bipartisan sponsorship. Direct financial impact on UNH, CI, and HUM is limited to a small book of business, but the legislation signals growing bipartisan appetite for PBM pricing reform that could expand to larger markets.
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UNH ($368.92), CI ($291.70), and HUM ($239.61) have rallied sharply over the past 30 days — UNH up 36.34%, CI up 9.35%, and HUM up 38.19% — primarily driven by broader market tailwinds, not PBM reform sentiment. The FEHBP-specific mandate in HR6610 is too narrow to explain these moves. Investors should treat this 4/10 impact score bill as a watch item: if the Oversight Committee schedules a markup or a Senate companion bill is introduced, the bearish case for UNH, CI, and HUM strengthens considerably. The market is currently pricing in zero probability of PBM reform passage. Any legislative progress would introduce downside risk to the PBM-heavy revenue streams of these stocks.
On December 11, 2025, Representative Auchincloss (D-MA) introduced HR6610, the Pharmacists Fight Back in Federal Employee Health Benefit Plans Act, with 32 cosponsors including Rep. Comer (R-KY), chairman of the House Oversight Committee. The bill was referred to the House Committee on Oversight and Government Reform and has no further action history — it remains in early legislative stages. The bill amends 5 U.S.C. §8904 to require all FEHBP health plans to mandate that their PBMs reimburse in-network pharmacies at the National Average Drug Acquisition Cost (NADAC) plus the lesser of 4% or $50, plus the state Medicaid dispensing fee. It also requires PBMs to pass 100% of manufacturer rebates through to patients at the point of sale by reducing coinsurance/copayments. There is no funding authorization — this is a regulatory mandate, not a spending bill. The three largest publicly traded PBMs — OptumRx ($UNH), Express Scripts ($CI), and Humana Pharmacy Solutions ($HUM) — administer prescription drug benefits for FEHBP plans. Under current practice, PBMs negotiate reimbursements below NADAC and retain a portion of manufacturer rebates as profit. HR6610 would eliminate both profit levers on the FEHBP book. However, FEHBP represents a small fraction of total PBM claims volume — the commercial market, Medicare Part D, and state Medicaid programs are far larger. The immediate financial impact on UNH, CI, and HUM is limited to tens-to-hundreds of millions annually — not a material earnings event for companies with $100B+ (UNH), $50B+ (CI), and $40B+ (HUM) in revenues. The real risk is precedent: bipartisan support for PBM reform, including the Oversight Committee chairman, signals that similar mandates could be proposed for Medicare Part D and commercial plans in future sessions. Over the trailing 30 days through April 30, 2026, UNH is up 36.34%, CI up 9.35%, and HUM up 38.19% — primarily driven by broader market and sector trends rather than this early-stage bill. The next legislative step is committee markup in the House Oversight Committee, which has not been scheduled. Without a Senate companion bill or committee action, the probability of passage in the 119th Congress remains low. Investors should monitor whether Chairman Comer advances the bill and whether a Senate version emerges — those events would materially increase the bearish thesis for large-cap PBMs.
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To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes.
Pharmacists Fight Back in Medicare and Medicaid Act
PBM FAIR Act
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