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Pharmacy benefit managers are driving up health care costs for employers and employees alike—and they must be reformed as soon as possible, Rep. Buddy Carter (R-GA), Sen. James Lankford (R-OK) and other members of Congress said at a bicameral, bipartisan Capitol Hill press conference Wednesday.

What’s going on: Rep. Carter, Sen. Lankford and other lawmakers—including Reps. Mariannette Miller-Meeks (R-IA), Raja Krishnamoorthi (D-IL) and Nanette Barragan (D-CA)—are calling on House and Senate leadership to advance PBM reform legislation in Congress’ year-end lame-duck session.

• The House passed a bipartisan PBM reform bill last December, and seven congressional committees—in both the House and Senate—have approved PBM bills during this Congress.
• The NAM, long a champion of commonsense PBM reform, offered manufacturers’ strong support for the lawmakers’ efforts.

What they said: “Democrats and Republicans [alike] … recognize that PBMs are decreasing the accessibility, the affordability and therefore the quality of health care in America,” said Rep. Carter, who showed the crowd photos of real patients facing difficulties accessing medications due to PBMs.

• “Congress must act before the end of the year to save our constituents’ lives. That’s why I’m leading a bipartisan letter to the House and Senate leadership urging them to prioritize PBM reform during end-of-year negotiations and ensure that the bipartisan efforts we have worked on through the 118th Congress are enacted into law.”
• Added Rep. Miller-Meeks, sponsor of the NAM-backed DRUG Act: “Every American who utilizes prescription medications experiences the impact that PBMs … have on our health care system. Patients everywhere—and our independent pharmacists—deserve a health care system where patients always come first.”

Why it’s important: PBMs often dictate the prices that patients pay at the pharmacy counter—and their business model incentivizes them to increase those prices for their own benefit.

• PBMs take a cut of a drug’s list price and pocket a large portion of rebate savings that are supposed to go back to patients and employers.
• In addition, they operate without transparency into their pricing decisions, making it more difficult for employers to reduce prices or access savings.

Now’s the time: “We want leadership to be able to take [PBM reform legislation] up in the end-of-the-year package,” Sen. Lankford said at the press conference. “We don’t want to tell … patients, ‘Wait another two years and maybe we’ll get into it in the next session.’ Let’s actually get into it in this session.”  

NAM advocacy: The NAM has been at the forefront of the fight for PBM reform. Last month, it launched a seven-figure ad campaign urging the passage of reforms during the lame-duck session.    

The last word: “Manufacturers and manufacturing workers are facing increasing and unsustainable health care costs as a direct result of PBMs,” said NAM Managing Vice President of Policy Chris Netram. “Manufacturers agree with Rep. Carter and the bipartisan, bicameral members of Congress calling for reform: Congress must act urgently—in the lame-duck session—to increase transparency, lower health care costs and protect manufacturing workers.”

FAME USA is revitalizing the manufacturing workforce with its global-best model of on-the-job training combined with classroom education. 

Created in 2010 by Toyota, the program was entrusted to the Manufacturing Institute, the NAM’s workforce development and education affiliate, in 2019. Since then, it has grown enormously, almost doubling in size under the MI’s stewardship.   

The past five years: FAME has scaled to more than 45 chapters across 16 states since the MI took over stewardship of the initiative—up from 20 chapters in 9 states. Employer support has grown, too, from 220 manufacturers to nearly 500 today.

• As a result of this growth, FAME boasts more than 1,300 enrolled students, 2,200 graduates and an impressive 90% employment rate upon graduation.
• And there’s much more coming soon: FAME plans to add eight more chapters by the beginning of the 2026 school year.  

Working with manufacturers: FAME offers two options for manufacturers looking for skilled workers.

• They can join an existing FAME chapter and benefit from the established employer collaborative. Or in locations where FAME doesn’t already have a presence or where the companies are building new facilities or undertaking large expansions, they can initiate a new FAME chapter to meet their greater need for talent.

General Mills: The food manufacturer was searching for more skilled workers for its Hannibal, Missouri, facility when it learned of FAME. In 2024, General Mills joined the Great River chapter in Illinois, which crosses state lines into Missouri, and committed to sponsoring five students.

• “We want the best talent at our manufacturing facilities, and we know that there’s tremendous talent in our communities. Partnering with FAME allows us to harness the talent in our local communities and get candidates excited about building a career with General Mills,” said Becky Crane, vice president, manufacturing & engineering at General Mills, during a recent panel discussion highlighting FAME.

Novelis: The leading producer of flat-rolled aluminum products and the world’s largest recycler of aluminum first partnered with FAME in 2015 through joint venture Logan Aluminum in Kentucky, as part of the SKY FAME chapter.

• “FAME provides an excellent forum for manufacturing companies in the same region to work together on providing the necessary exposure and skills to our future workforce,” said Dev Ahuja, executive vice president and chief financial officer at Novelis.
• Approximately 40 employees at Novelis are FAME graduates, and the company expects this number to grow as it expands participation across states.
• Novelis has also found success with FAME during greenfield projects. The Novelis plant in Guthrie, Kentucky, began partnering with the HOPFAME chapter in 2018 during construction of its new facility, and the company is now a founding employer of the FAME chapter in Bay Minette, Alabama, where it is constructing an aluminum plant that will create up to 1,000 jobs.

The bottom line: “FAME is not just a training program; it’s a transformative solution for employers looking to cultivate a skilled workforce that meets their specific needs. By engaging with FAME, companies can tap into local talent, foster economic growth and build a sustainable pipeline of skilled workers,” said MI President and Executive Director Carolyn Lee.

• “We encourage employers to join this collaborative effort—together, we can empower our communities and ensure the future of manufacturing is in America.”

Get involved: Learn more here about FAME and how you can tap into this global-best training resource. And don’t forget to follow FAME USA on LinkedIn.

The U.S. Court of Appeals for the D.C. Circuit should overturn a lower court’s ruling that the Securities and Exchange Commission lacks the authority to regulate proxy advisory firms, the NAM said in a recently filed brief.

What’s going on: The Nov. 15 brief asking the appeals court to overturn a February ruling by the D.C. District Court is the latest in a years-long campaign by the NAM to ensure reasonable regulation of proxy firms. These powerful, unregulated entities often dictate how shareholders vote on proxy ballot proposals that come before public companies.

• “Since the passage of the Securities Exchange Act of 1934 in the wake of the Great Depression, the Securities and Exchange Commission has regulated proxy solicitation, so shareholders can confidently vote based on transparent and reliable information,” according to the NAM brief. “Accordingly, since the proxy voting advice industry emerged four decades ago, those firms have been subject to SEC regulation.”
• Institutional Shareholder Services, the largest and most influential proxy firm, “would rather not be regulated at all”—but “[t]he record overwhelmingly establishes that proxy firms ‘solicit’ proxies under any reasonable definition,” subjecting them to SEC oversight as required by the Exchange Act.

Why it’s important: Proxy firms wield enormous influence over both manufacturers and Main Street investors, the NAM said.

• “ISS and its main competitor, Glass Lewis, control 97% of the proxy advice market and together influence nearly 40% of the U.S. shareholder vote,” the NAM told the court in its brief.
• Further, proxy firms operate with undisclosed conflicts of interest, their reports can contain errors and misleading statements and their “robo-voting” services give them the authority to cast investors’ proxy votes with no review or input by the investors themselves.

NAM on the front lines: In July 2020, after years of NAM advocacy, the SEC finalized a rule instituting critical proxy firm reforms. ISS quickly brought a legal challenge, and the NAM intervened in the case to ensure a robust defense of the rule.

• Following the change in presidential administrations in 2021, in separate lawsuits the NAM successfully challenged the Biden SEC’s refusal to enforce the 2020 rule and its rescission of critical portions of the rule.
• After an unfavorable decision from the D.C. district court in the ISS challenge, the Biden SEC declined to pursue an appeal, effectively disclaiming its authority to regulate proxy firms. The NAM took the lead as intervenor-appellant in the case, so manufacturers are now the sole bulwark against proxy firms’ unchecked power. A victory in the D.C. Circuit for the NAM would make the proxy firms subject to the 2020 rule’s important reforms.

Former SEC officials agree: A group of former SEC commissioners and staff authored an amicus brief in support of the NAM’s position.

• The brief chronicles the commission’s 50-year history of affirming that proxy firms are engaged in solicitation. The officials make clear that “stripping the SEC of its long-standing and Congressionally conferred power to regulate the firms” would “seriously harm the investing public by decreasing fairness and honesty in the markets—exactly the opposite of what Congress was trying to accomplish in the Exchange Act.”

What’s next: ISS’s response to the NAM’s brief is due in the coming weeks, and the court likely will schedule oral argument for early 2025.

In September, the S&P CoreLogic Case-Shiller U.S. National Home Price NSA Index recorded a 3.9% annual gain, down from 4.3% in August. Similarly, the 10-City Composite saw an annual increase of 5.2% in September, a decrease from 6.0% the previous month, while the 20-City Composite rose 4.6% year-over-year, down from 5.2% in August. Among the 20 cities, New York again posted the highest annual gain at 7.5%, followed by Cleveland at 7.1% and Chicago at 6.9%. Denver had the lowest annual increase at 0.2%.

On a month-over-month basis, the U.S. National Index dropped 0.1% before seasonal adjustment but increased 0.3% after adjustment. The 20-City and 10-City Composites saw 0.3% and 0.4% decreases pre-adjustment, while posting 0.2% and 0.1% increases post-adjustment, respectively.

While home prices stalled in the third quarter, the slight downtick could be attributed to technical factors, since the seasonally adjusted figures exhibited a 16th consecutive all-time high. The Northeast and Midwest continue to display above-trend price growth, growing 5.7% and 5.4%, respectively, while the South reported its slowest growth in more than a year, rising 2.8%.

Consumer confidence rose in November to 111.7 from 109.6 in October. The improvement in confidence in November was based largely on labor market optimism, including future job availability. Meanwhile, consumers’ expectations about future business conditions were unchanged, and they were slightly less positive about future income

The Present Situation Index, reflecting current business and labor market conditions, increased 4.8 points to 140.9. The Expectations Index, which reflects consumers’ short-term outlook for income, business and labor market conditions, ticked up 0.4 points to 92.3, well above the recession signal threshold of 80. Consumers’ assessments of current business conditions improved, with slightly less consumers saying business conditions were “good” but less views of the current conditions being “bad.” Consumers also felt more positive about future labor market conditions, with less consumers saying jobs were “hard to get.”

On the other hand, consumers’ assessments of future income fell slightly in November, with 19.0% anticipating income growth, down from 19.5% in October. Although elevated prices remain top of mind, inflation expectations decreased from 5.3% to 4.9% in November, and expectations for higher interest rates continued to decline. Buying plans for homes stalled, while purchasing plans for new cars improved slightly. Purchase plans for most big-ticket appliances were down. Concerns about a recession occurring in the next 12 months fell further in November and was at the lowest proportion since the question was first asked in July 2022.

Manufacturing activity in the Fifth District remained sluggish in November. The Fifth Federal Reserve District consists of Virginia, Maryland, the Carolinas, the District of Columbia and most of West Virginia. The composite manufacturing index remained at -14 in November. Among its components, shipments decreased from -8 to -12, new orders inched down from -17 to -19, and employment rose from -17 to -10. The vendor lead time index edged down from 6 to 4 in November, and firms continued to report declining backlogs. Companies also grew slightly more pessimistic about local business conditions, with the index remaining solidly in negative territory. The average growth rate of prices paid decreased in November, while the rate of prices received increased modestly.

Expectations for future shipments and new orders both increased further into positive territory, suggesting that firms continue to anticipate improvement in these areas. Expectations for backlogs and the outlook for future local business conditions improved, with both indicators remaining positive. Firms continue to exhibit a more cautious approach to equipment and software spending, as expectations became slightly more negative. Spending on capital expenditures also fell, remaining negative.

In November, Texas factory activity was relatively flat, but most indicators of manufacturing were in negative territory. The production index turned negative again to -0.9, after rising to 14.6 in October. The new orders index pushed further into negative territory to -11.9, indicating continued declines in demand. Meanwhile, the capacity utilization and shipments indexes both turned negative to -4.8 and -5.9, respectively.

Perceptions of business conditions were mixed in November, and the general business activity index held relatively steady at -2.7. Meanwhile, the company outlook index turned positive, improving to 5.8. The outlook uncertainty index, which has been volatile lately, dropped more than 10 points to 5.9 after a significant increase in the previous month.

Labor market indicators suggested some employment growth and steady workweeks in November. The employment index soared 10 points to 4.9, while the hours worked index rose nearly six points to 0.3, both turning positive. About 19% of firms reported hiring, while 14% noted layoffs. Moderate upward pressure on prices and wages persisted, with all indexes roughly aligned with historical averages. The wages and benefits index fell to 18.6. On the other hand, the raw materials prices index spiked more than 12 points to 28.5, while the finished goods prices index inched up to 8.8.

The outlook for future manufacturing activity remained optimistic. The future production index edged up to 44.0, a three-year high. Similarly, the future general business activity index rose slightly to 31.2, also a three-year high.

Existing home sales increased 3.4% in October and 2.9% from October 2023. Housing inventory rose to 1.37 million units, reflecting a 0.7% increase from September and a 19.1% boost from last year. The median existing home price was $407,200, up 4.0% from last year, with all four U.S. regions reporting price increases.

Single-family home sales rose 3.5% from September, with the median price increasing 4.1% from October 2023 to $412,200. Condo and co-op sales grew 2.7% in October but declined 7.3% from the previous year, with the median price up 1.6% from the prior year to $360,300.

Homes were typically on the market for 29 days in October, up from 28 days in September and 23 days in October 2023. First-time buyers made up 27% of sales, up slightly from 26% in September but down from 28% in October 2023. All-cash sales accounted for 27% of transactions in October, down from 30% in September and 29% a year ago. Meanwhile, investors or second-home buyers represented 17% of homes purchased in October, up from 16% in September and 15% a year ago. Distressed sales represented 2% of purchases in October, unchanged from the previous month and last year.

Building permits fell 0.6% in October and 7.7% over the year. Permits for single-family homes rose 0.5% in October but declined 1.8% over the year. Permits for buildings with five or more units fell 3.0% from September and plummeted 20.9% over the year.

In October, housing starts decreased 3.1% over the month and 4.0% over the year. Additionally, starts for single-family homes fell 6.9% from September but just 0.5% from October 2023. Meanwhile, starts for buildings with five or more units increased 9.8% from September but declined 12.6% over the year.

Housing completions decreased 4.4% from September but jumped 16.8% from October 2023. Single-family home completions fell 1.4% from September and 0.2% over the year. Completions for buildings with five or more units dropped 9.0% over the month but soared an incredible 61.4% from October 2023.

The Conference Board Leading Economic Index for the U.S. fell 0.4% to 99.5 in October, following a 0.3% decline in September. Over the past six months (April to October 2024), the LEI has decreased 2.2%, which is slightly worse than the 2.0% decline in the prior six months (October 2023 to April 2024). Weakness in new factory orders continued to be the most significant drag on the index.

In October, manufacturing hours worked fell by the most since December 2023, while unemployment insurance claims rose and building permits declined, partly due to the impact of hurricanes. In addition, the yield curve inversion continued to weigh on the LEI. On the bright side, the LEI stopped signaling an impending recession in October.

Meanwhile, the Coincident Economic Index was unchanged for a second consecutive month at 112.8 but has increased 0.8% over the past six months. On the other hand, the Lagging Economic Index inched down 0.1% in October to 118.7 and has contracted 0.8% over the past six months, which partially reversed the 1.2% growth over the prior six-month period (October 2023 to April 2024).