Since 2017, Wisconsin (WI) has struggled to implement effective reforms to regulate pharmacy benefit managers (PBMs) and bring transparency to prescription drug pricing.

In March 2021, the passing of Wisconsin Act 9 seemed like it might be a turning point... But instead of establishing true oversight, the final version of this legislation barely scratched the surface, establishing only minimal and practically meaningless regulation of PBMs. Despite overwhelming bipartisan support and one of the most widely-backed legislative hearings in WI history, no vote on the bill was scheduled. It took 11,632 patient petitions just to force a vote, called by Assembly Speaker Robin Vos. Unfortunately, when Speaker Vos finally convened a meeting—dominated, of course, by the insurance lobby—the bill was gutted. Nearly 90% of the provisions on PBM reform were stripped away.

The harsh reality? One man—Speaker Robin Vos—overruled 104 cosponsors and massive grassroots support.

In 2023, another PBM reform bill was introduced; unsurprisingly, under Vos’ leadership, it never even made it to a vote. By April 2024, the effort to pass meaningful PBM reform in the WI Legislature had once again failed.

Then, in January 2024, tragedy struck. 22-year-old Wisconsonite Cole Schmidtknecht lost his life, a victim of PBM abuse. At the start of 2024, his routine steroid medication that had helped control his asthma was taken off his insurance plan's formulary of covered drugs without notice. The price skyrocketed from $66 in 2023 to $539.19 in 2024—a cost he couldn’t afford. He died just days after opting to go without his inhaler.

Now, in 2025, we have one more chance to achieve real PBM reform in WI, but we must build an unstoppable grassroots movement to make it happen.