The bill also would require that a PBM pass all negotiated rebates on to the payers or patients and prohibit PBMs from steering patients toward their own pharmacies and prohibit a PBM.

One of the sponsors of the PBM bill is the California Pharmacists Association.

Related: Pennsylvania governor signs pharmacy benefit manager bill

California Gavin Newsom, who is also a Democrat, vetoed another Wiener PBM licensing bill in September 2024. Newsom argued in the veto message that the state should get more data about the state's pharmacy delivery system before imposing broad new rules on PBMs.

"We need more granular information to fully understand the cost drivers in the prescription drug market and the role that PBMs play in pricing," Newsom said.

Wiener's $35 insulin price cap bill would complement a new federal law that caps what Medicare enrollees pay for insulin out of pocket for a 30-day supply at $35 per month.

Unlike the federal law, Wiener's bill would apply to commercial health insurance and health maintenance organization coverage rather than to Medicare.

Many health insurers have talked about programs that limit what people with diabetes pay for insulin, but about 80% of people who use insulin have had to assume large amounts of credit card debt to pay for their insulin, and about 25% of people with diabetes are using less insulin than their physicians have recommended because they can't afford the full dose, Wiener said.

The American Diabetes Association sponsored the insulin cost cap bill.

Newsom vetoed an earlier version of the insulin cost cap bill in October 2023. He noted in the veto message for that bill that California is working with Civica Rx, a nonprofit drugmaker, to create its own brand of insulin.