Washington, D.C. — Patients Rising strongly opposes the substitute amendment to SB271 (House Substitute 26109393D) now under consideration in the Virginia General Assembly. The proposal would extend the federal Medicare drug price negotiation program’s “Maximum Fair Price” beyond Medicare and apply it across Virginia’s broader healthcare market.

While the bill is presented as a solution to drug affordability, it raises serious concerns for patients who depend on consistent access to the medicines their doctors prescribe.

The substitute would effectively apply federal price controls to parts of Virginia’s healthcare system that were never intended to be part of the Medicare negotiation program. Policies like this may sound appealing, but they do not guarantee that patients will see lower costs at the pharmacy counter and could create new risks for access to treatments.

“This proposal focuses on government price caps rather than the real problem patients face — what they pay out-of-pocket,” said Terry Wilcox, Co-Founder and Chief Mission Officer of Patients Rising. “Patients don’t experience the healthcare system through policy theory. They experience it when they stand at the pharmacy counter wondering if they can afford the medicine their doctor prescribed.”

The substitute also creates a new state advisory panel focused on prescription drug pricing and would impose civil penalties tied to the federally negotiated Medicare price for certain drugs. Patients Rising believes policies that reach this far into healthcare markets should be evaluated carefully to ensure they actually benefit patients.

Another important concern is the limited number of patients who could realistically see any benefit from policies tied to the first group of federally negotiated drugs.

Nationally, only a small portion of Americans use these medicines. In Virginia, fewer than two percent of residents outside Medicare would potentially be affected. Even for those patients, the bill contains no clear guarantee that any savings would reach them directly in the form of lower out-of-pocket costs.

At the same time, applying federal price controls across broader healthcare markets risks unintended consequences that could ultimately affect access to medicines for many more patients.

“Patients need real relief from healthcare costs,” Wilcox said. “But policies that focus on setting prices instead of fixing what patients actually pay can miss the mark. Patients deserve solutions that lower costs at the pharmacy counter without putting access to treatment at risk.”

Patients Rising believes meaningful affordability reforms should focus on the barriers patients face every day, including high deductibles, complex insurance benefit designs, and opaque pricing practices that prevent savings from reaching patients.

Patients Rising urges Virginia lawmakers to reconsider this substitute amendment and instead pursue patient-centered solutions that improve affordability while protecting access to the medicines patients rely on.