A fight over prescription drug pricing in Delaware is offering an early look at a much larger change coming to employer health benefits. The state’s health benefits board oversees coverage for more than 135,000 public employees, retirees, and family members, while its Group Health Insurance Plan is projected to cost nearly $1.6 billion in fiscal 2027.
At the center of the dispute is how much information employers and government health plans can obtain from pharmacy benefit managers, or PBMs. Delaware Sen. Ray Seigfried has pushed the state to obtain more detailed pricing and rebate information, arguing that greater visibility could help identify hidden costs and give plan sponsors more leverage when negotiating drug contracts.
The issue is becoming more important nationally. The Consolidated Appropriations Act of 2026, signed Feb. 3, requires qualifying self-funded employer plans—generally those with 100 or more participants—to receive detailed PBM reports on drug pricing and rebates twice a year, along with full rebate pass-through. For calendar-year plans, most of the federal requirements are scheduled to begin Jan. 1, 2029, rather than taking effect immediately.
That delay gives benefits brokers and employers time to prepare, but it also creates a strategic opportunity. Access to pricing data will matter only if plan sponsors can actually analyze it, reconcile rebates and use the information during PBM negotiations. The Delaware experience suggests that simply having a legal right to the data may not be enough; employers will need the systems and expertise to turn disclosure into lower costs.
For brokers, that could make PBM data readiness a more important part of their role. Identifying which clients fall under the new federal threshold, reviewing existing PBM contracts, and preparing for semiannual reporting before 2029 could give employers a stronger negotiating position when the new transparency rules begin to have practical effect.
