Healthcare
Healthcare is manufacturers' top cost pressure - and team members' top concern. Manufacturers are leading with coverage and pressing for policies that make quality care more affordable.
Healthcare
Healthcare is manufacturers’ top cost concern. The NAM has a prescription.
Manufacturers are deeply committed to the health of their workforce — employer-sponsored insurance is the bedrock of American coverage. But relentless cost increases threaten manufacturers’ ability to keep offering it, and hit small and medium-sized companies hardest. The NAM’s roadmap charts a practical path to lower costs without sacrificing care or innovation.
Sources: NAM Q1 2026 and Q4 2025 Manufacturers’ Outlook Surveys; KFF 2025 Employer Health Benefits Survey. Small (75%) and medium (78%) manufacturers feel the cost burden most.
The roadmap
Manufacturers’ roadmap to lower healthcare costs
A practical, twelve-point agenda — distilled here into six priorities — to bring down costs for manufacturing workers and all Americans while protecting access and innovation.
Rein In PBMs
Pharmacy benefit managers are underregulated middlemen that drive up drug costs. Building on new transparency and 100% rebate pass-through, the NAM is fighting to delink PBM pay from drug list prices.
Restore the 340B Program
Return the program to its original purpose — helping low-income and underserved patients — rather than padding hospital profits at the expense of employer-sponsored coverage.
Expand Affordable Options
More flexible, lower-cost coverage: larger Health Savings Accounts, Association Health Plans codified under ERISA, broader ICHRA adoption and expanded access to telehealth.
Protect Access to Innovation
Reject most-favored-nation and other price controls that choke off R&D — and keep life-saving, cost-saving medicines accessible and affordable for workers and their families.
Preserve IP & a Strong FDA
Defend the intellectual property — and the Bayh-Dole framework — that turns research into cures, and fully resource an FDA committed to gold-standard, evidence-based science.
Defend the Foundation
Protect ERISA’s federal preemption and the employer-sponsored insurance tax exclusion — the legal and financial bedrock of manufacturers’ ability to offer benefits nationwide.
Momentum
Reform is already taking hold
Manufacturers’ advocacy has already begun to deliver lower costs and more transparency — with more to come.
“These reforms are an important step toward delivering long-overdue transparency and accountability for the underregulated middlemen who drive up costs at the pharmacy counter.” — Jay Timmons, NAM President & CEO, on PBM reform
Source: NAM, Prescription for a Healthy Workforce: Manufacturers’ Roadmap to Lower Healthcare Costs (2026).
Employer-Sponsored Coverage
Manufacturers lead every industry in offering health coverage
Employer-sponsored insurance is how manufacturing families get their care — and manufacturers offer it at the highest rate of any sector. Even as premiums climb, manufacturers keep finding flexible ways to deliver coverage: adjusting plan designs, expanding options and pressing for policies that make good benefits affordable to provide.
Providing health coverage is how manufacturers compete for talent and keep a healthy, stable workforce — which is why lowering the cost of offering it sits at the center of the NAM’s healthcare agenda.
Read: Shaping Up HealthcareSources: Kaiser Family Foundation Employer Health Benefits Survey; NAM Manufacturers’ Outlook Survey.
New Report · June 2026
Industrial Immunity: Inoculating the Manufacturing Economy
Vaccines keep manufacturing workers healthy and on the job — and the NAM’s new report quantifies what prevention is worth to the manufacturing economy, from absenteeism and caregiving costs to health benefit spending, along with a science-based policy agenda that strengthens the workforce.
Sources: CDC Foundation (2015), inflation-adjusted using the BLS CPI; NAM analysis of CDC, BLS and Census Bureau data.
Policy Recommendations
Key Policy Actions
Comments on FDA’s Proposed Exclusion of GLP-1s from the 503B Bulks List
The NAM’s comments to the FDA supporting its proposal not to add semaglutide, tirzepatide and liraglutide to the 503B Bulks List (Docket No. FDA-2018-N-3240). The NAM urges the agency to finalize the proposal without delay, citing thousands of adverse event reports and more than 75,000 recalled vials of compounded GLP-1s that bypass the FDA’s safety and efficacy standards.
Letter to House Energy and Commerce on Healthcare Price Transparency
The NAM’s letter to the House Energy and Commerce Health Subcommittee for its hearing “Lowering Healthcare Costs for All Americans: Examining Policies to Increase Healthcare Transparency.” The NAM urges user-friendly access to complete claims and price data for employer plan sponsors—paired with hospital and insurer price transparency updates—so manufacturers and their workers can make more informed healthcare decisions.
Letter to House Judiciary on Medicines and IP: Balancing Innovation and Access
The NAM’s letter for the House Judiciary IP Subcommittee’s hearing “Medicines and IP: Balancing Innovation and Access,” underscoring the Bayh-Dole Act’s critical role in biopharmaceutical innovation and commercialization. The NAM highlights the $2.3 billion, 10-to-15-year investment behind each new medicine and urges Congress to preserve the reliable patent protections that make those investments possible.
Letter to Senate HELP on Building the FDA of the Future
The NAM’s recommendations to Senate HELP Chair Bill Cassidy following the committee’s February 2026 FDA modernization report. The NAM calls for a whole-of-FDA approach—reliable timelines, clear guidance and Gold Standard Science across every center—paired with targeted, center-specific reforms so safe, innovative products reach patients faster.
Letter to House Education and the Workforce on the PBM Business Model
The NAM’s letter for the subcommittee hearing “Profits Over Patients: The PBM Business Model Under Scrutiny.” The NAM details how pharmacy benefit managers drive up costs by pocketing rebates, tying patient cost-sharing to list prices and using spread pricing, and presses for transparency and delinking reforms as 94% of manufacturers face higher premiums for 2026.
Comments to HRSA on the 340B Rebate Model Pilot Program
The NAM’s comments to HRSA’s Office of Pharmacy Affairs on the proposed 340B Rebate Model Pilot Program (Docket No. HRSA-2026-93942). The NAM urges the pilot’s expeditious establishment to help realign a program whose rapid expansion has contributed to rising premiums for employer-sponsored insurance.
Letter to Senate HELP on Making Medicines More Affordable
The NAM’s letter for the Senate HELP hearing “Making Medicines More Affordable: How Competition Can Lower Drug Prices.” The NAM warns that price controls like “most favored nation” mandates fail to value innovation and limit patient access, and urges competition-focused reforms that lower costs without stifling the development of new treatments and cures.
Comments on the Labor Department’s PBM Fee Transparency Rule
The NAM’s comments supporting the DOL’s proposed rule “Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure” (RIN 1210-AB37). The NAM applauds requiring PBMs to disclose fee information to self-funded employer plans and recommends strengthening the rule so fees reflect the value PBMs provide rather than practices designed to maximize their profits.
Letter Supporting the SAFE Drugs Act (H.R. 6509/S. 3794)
The NAM’s letter to Senate HELP and House Energy and Commerce leadership supporting the Safeguarding Americans from Fraudulent and Experimental (SAFE) Drugs Act. The NAM urges committee action to strengthen FDA oversight of compounding pharmacies, citing thousands of adverse-event reports tied to unapproved compounded drugs.
Comments on the GUARD Model: Guarding U.S. Medicare Against Rising Drug Costs
The NAM’s comments to CMS on the proposed GUARD Model (Docket No. CMS-2025-1888), which would import foreign reference prices into Medicare. The NAM warns that importing flawed foreign price controls would impede lifesaving biopharmaceutical innovation and exceed CMMI’s authority, and urges CMS to withdraw the proposed model.
Comments on the GLOBE Model: The Global Benchmark for Efficient Drug Pricing
The NAM’s comments to CMS on the proposed GLOBE Model, which would tie Medicare drug prices to foreign “most favored nation” reference prices. The NAM warns that importing flawed foreign price controls would impede lifesaving biopharmaceutical innovation and exceed CMMI’s authority, and urges CMS to withdraw the model in favor of trade policies that secure fair market access for U.S. innovators abroad.
Comments on FDA’s RFI on Increasing Access to Nonprescription Drugs
The NAM’s comments to the FDA on its request for information about expanding access to over-the-counter medicines (Docket No. FDA-2025-N-4731). The NAM outlines reforms to support OTC innovation and availability, which save workers time and money and help chip away at rising healthcare costs amid a physician shortage.
Letter to House Energy and Commerce on Health Insurance Affordability
The NAM’s letter for the Health Subcommittee hearing “Lowering Healthcare Costs for All Americans: An Examination of Health Insurance Affordability.” The NAM presses for PBM reform, 340B reform and greater transparency into insurers’ vertically integrated subsidiaries as 94% of manufacturers face higher health insurance premiums for 2026.
Letter to House Ways and Means for Its Hearing with Health Insurance CEOs
The NAM’s letter for the committee’s full hearing with health insurance company CEOs, examining how insurers, PBMs and vertical integration contribute to rising costs. The NAM builds on the One Big Beautiful Bill Act’s (H.R. 1) telehealth and HSA wins and urges further reforms that put more money back in workers’ pockets.
Letter Supporting Healthcare Reforms in the Consolidated Appropriations Act, 2026
The NAM’s letter to House and Senate leadership backing sections 6224, 6604, 6701 and 6702 of H.R. 7148, the Consolidated Appropriations Act, 2026. The NAM highlights PBM accountability reforms, the rare pediatric disease priority review voucher extension and other provisions that address the rising cost of care for manufacturers and their workers.
Letter to Senate HELP on Making Healthcare Affordable Again
The NAM’s letter for the hearing “Making Healthcare Affordable Again: Healing a Broken System.” The NAM opposes price controls that would undermine innovation and urges PBM and 340B reforms to lower costs across the employer-sponsored insurance system that covers more than 160 million Americans.
Letter to the Senate Finance Committee on the Rising Cost of Healthcare
The NAM’s letter for the committee’s hearing “The Rising Cost of Healthcare: Considering Meaningful Solutions for All Americans.” The NAM urges the committee to advance the bipartisan Modernizing and Ensuring PBM Accountability Act and 340B reform to relieve pressure on the employer-sponsored coverage manufacturers provide.
Comments on the FDA PreCheck Program for Onshoring Drug Manufacturing
The NAM’s comments to the FDA on the proposed PreCheck program (Docket No. FDA-2025-N-2489) to speed approval of domestic pharmaceutical manufacturing facilities. The NAM supports early agency engagement on facility design, construction and inspections, and recommends additional fixes so new U.S. capacity comes online faster.
Letter to Senate HELP on the Future of Biotech
The NAM’s letter for the committee’s hearing on the future of biotechnology. The NAM urges reconsideration of the IRA’s Medicare price controls and the small-molecule “pill penalty,” warning that they threaten the R&D pipeline behind lifesaving cures and U.S. biopharmaceutical leadership.
Letter to Senate HELP on the Growth and Patient Impact of the 340B Program
The NAM’s letter for the committee’s 340B hearing, detailing how the program’s rapid expansion—now the second-largest federal healthcare program—added roughly $23 billion in employer-based health costs in 2023. The NAM urges reforms that restore the program’s original intent of serving low-income and underserved patients.
Letter to House Ways and Means on Tax-Exempt Hospitals and the 340B Program
The NAM’s letter for the Oversight Subcommittee hearing on tax-exempt hospital spending unrelated to community benefit. The NAM shows how 340B’s expansion raises premiums for manufacturers—about $137 more per single plan and $415 per family plan each year—and urges accountability to realign the program with congressional intent.
Lower costs, healthier workers
Manufacturers can’t keep absorbing unsustainable healthcare costs. Help the NAM advance a practical roadmap that protects coverage, care and innovation.
