Lawmakers press EBSA on PBM transparency, claim denials and mental-health parity enforcement

Lawmakers repeatedly pressed Assistant Secretary Daniel Aronovich about EBSA's plans to tackle opaque pharmacy benefit manager practices, improper claim denials and lapses in mental-health parity enforcement during a House Education and Workforce subcommittee hearing.

Representative Courtney and others emphasized the Consolidated Appropriations Act of 2026 language and asked whether EBSA's proposed transparency regulation will cover a broad set of covered service providers beyond PBMs. Aronovich said EBSA's transparency notice focused on PBMs but that the agency extended comment periods, received hundreds of submissions and is reviewing how to harmonize administration rules with congressional language. "You have my commitment," he said, "that is what we're focused on."

Several members recounted concrete patient harms they said resulted from alternative funding programs or claim denials. Representative Macbeth described cases in which an employer-funded alternative program denied a patient access to a life-saving oncology drug for six months, and a cystic fibrosis patient who lost access to modulator therapy for six months resulting in hospitalization and lung damage. "If the facts are as you stated, that's wrong," Aronovich replied, calling such delays "outrageous" and pledging to prioritize enforcement of improper claim denials and oversight of alternative funding programs.

On mental-health parity, Representative Norcross pressed Aronovich on reports that EBSA would not enforce aspects of a parity final rule. Aronovich said EBSA had restated enforcement priorities and listed addressing barriers to mental health as a top priority, but also said litigation and administrative constraints limit what he could discuss in detail. "We are in litigation, and so I can't talk about the comparative analysis," he said, while adding, "We are 100% committed to knocking down every possible barrier to mental health."

Members asked what civil penalties or other remedies EBSA can impose for parity or denial violations. Aronovich said statutory authority is limited in some areas and that EBSA is using the tools it has under ERISA, including disclosure rules and fiduciary-process authorities, and pursuing enforcement against service providers where strategic impact is greatest.

The committee did not vote on legislation; members indicated interest in bipartisan follow-ups and left the record open for further submissions.