Justin Leventhal

What if opening a hospital required proving there aren’t already “too many”? In much of the U.S., that’s reality. Certificate of Need (CON) laws force healthcare providers to get government approval before opening, expanding, or even upgrading equipment—regardless of patient demand. The result is a system that protects incumbents while patients face higher prices and fewer options. Read more by @JustinLeventhal: theamericanconsumer.org/2026/03/how-st…

Healthcare access isn’t just a workforce issue—it’s a competition issue. When APRNs and physician assistants are allowed to practice independently: • Patients get more options • Wait times shrink • Costs come down Expanding scope of practice changes that dynamic—bringing more providers into the system and forcing improvements in price and service. Read more from @JustinLeventhal: theamericanconsumer.org/2026/03/the-ec…

What if you knew the cost of your care before treatment? That’s not radical—it’s how markets are supposed to work. The U.S. already requires hospital price transparency. But most providers still don’t make prices accessible when patients actually need them. Prices shouldn’t come after the bill. They should come before the care. Read more from @JustinLeventhal's Op-Ed: theamericanconsumer.org/2026/03/dc-jou…

Red tape is holding back cheaper medicines. Costly requirements, confusing naming rules, and limited interchangeability are discouraging biosimilar development. Smarter regulation could unlock real competition and lower prices for patients. Read more from @JustinLeventhal's latest Op-Ed: theamericanconsumer.org/2026/03/realcl…

The reform also requires PBMs to pass through 100% of rebates and discounts to plans and patients—ending incentives to favor high-priced drugs with bigger rebates. That’s a win for consumers. The downside? Implementation is delayed until 2028. Transparency postponed is relief delayed—but once in effect, these reforms will put downward pressure on drug prices and restore accountability to the system.

After years of stalled reform, Congress has finally taken on one of the biggest drivers of high drug prices: pharmacy benefit managers (PBMs). The new Consolidated Appropriations Act brings long-overdue transparency to a market where middlemen have operated in the shadows—retaining rebates and controlling pricing information. Markets require transparency. When patients, employers, and insurers can see the true costs, competition works and prices fall. Read more from @JustinLeventhal here: theamericanconsumer.org/2026/02/congre…

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(7) Policy reform should be simple: remove barriers to DTC sales, protect manufacturers from PBM retaliation, and let them compete directly for patients’ dollars. Do that, and you don’t need MFN. Prices fall organically. Access improves. Innovation survives. Patients win.

(6) The real enemy of affordable drugs isn’t list prices—it’s the opaque PBM system that blocks DTC and penalizes manufacturers who sell directly to patients at lower prices.

(1) Direct-to-consumer (DTC) pharmaceutical sales are the most promising drug-pricing reform in years. They cut out middlemen, expose real prices, and let patients buy medicine like consumers—not pawns in a rebate game. It works so well the government is getting in with TrumpRX.

PBMs favor high-cost drugs because rebates reward higher list prices, even when cheaper generics exist. That disconnect cuts patients out of the market, drives up insurer costs, and ultimately raises premiums for everyone.

(14) PBM transparency plus full rebate passthrough won’t fix everything, but it strikes at the core distortion in drug pricing, producing a more patient-oriented prescription drug market.

(13) This isn’t price controls or micromanagement. It’s disclosure and incentive alignment—forcing PBMs to compete on real value rather than financial engineering.

(1) For years, pharmacy benefit managers (PBMs) have operated in a black box—deciding which drugs patients get and what they cost, while no one can see the real costs. The PBM provisions in the Consolidated Appropriations Act of 2026 start to crack that box open.