California’s ledger is already burdened with policies that look appealing in theory but translate into long-term structural liabilities. With the passage of Senate Bill 41, that burden has only grown heavier. Marketed as pharmacy benefit manager (PBM) reform, the Department of Finance made clear months ago what this bill really is: an unfunded mandate with consequences that Californians will now be forced to absorb.

Those consequences start with the price tag. The Department of Managed Health Care has warned of millions in new annual costs to expand its regulatory staff and audits. The Department of Justice anticipates investigation expenses that could escalate into the tens of millions each year. Even the Department of Insurance projects multimillion-dollar obligations. These are not one

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