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The NAM called on the Senate Finance Committee to take action to lower the cost of employer-sponsored health insurance, which is one of manufacturers’ top concerns as reported in the NAM Q3 2025 Manufacturers’ Outlook Survey.

What’s going on: Employer-sponsored insurance is the bedrock of the United States’ health care system, covering over 160 million people across industries. “[M]anufacturers provide health care benefits so they can effectively attract and retain employees, to maintain a healthy and productive workforce, and because they believe it is the right thing to do for their workers,” the NAM told the Senate Finance Committee ahead of a Wednesday hearing on the rising cost of health care, citing the findings of a 2023 NAM health care study.

What must be done: “Manufacturers are committed to continuing to offer health insurance to their employees, but substantive, bipartisan reforms are needed to realign our health care system to put patients first and reduce costs for companies, workers and their families.” These reforms include the following:

• Reforming pharmacy benefit managers: These largely unregulated middlemen drive up the cost of health care by tying patient cost-sharing to list prices, pocketing manufacturer rebates and obscuring alarming business practices. The NAM supports the Modernizing and Ensuring PBM Accountability Act, which passed out of the Finance Committee on a bipartisan basis last Congress.
• Improve data transparency and accessibility: “It is … important that employer plan sponsors have user-friendly access to their complete data in order to make informed choices about their plan’s operations,” the NAM said, adding that transparency also helps patients make better decisions.
• Reform the 340B program: The expansion of the federal 340B Drug Pricing Program beyond congressional intent has resulted in “approximately $23 billion in additional employer-based health care expenses,” the NAM said. Reforming the program would keep these funds in the pockets of manufacturers and their employees. 
• Strengthen ERISA and protect its federal preemption: ERISA allows manufacturers to provide uniform, yet tailored, benefits to workers across multiple states, but reforms are needed to address regulatory burdens. ERISA’s federal preemption is critical to the operation of ESI for multistate employers and must be maintained so manufacturers can avoid having “to comply with a patchwork of cumbersome and potentially conflicting state-based rules.”

The committee’s angle: Senators on the Finance Committee shared their urgency in addressing rising health care costs. In their opening remarks, both Chair Mike Crapo (R-ID) and Ranking Member Ron Wyden (D-OR) noted the need to crack down on middlemen, such as PBMs, which they have addressed via the Modernizing and Ensuring PBM Accountability Act. The NAM will continue to work with the committee on this and other key health care cost issues.