If you have never heard of PBMs, you are probably not alone. However, starting next month, Hoosiers are expected to quickly learn all about pharmacy benefit managers and how their practices are driving up the price of some prescription medicine. It is important to understand what happens during the time your medicine is manufactured and before it is dispensed.

Antonio Ciaccia, president of 3 Axis Advisors and a leading health policy expert, said we have a highly dysfunctional drug distribution system which spits out increasingly inflated medicine prices.

"Drug manufacturers sell drugs to wholesalers," he said. "Wholesalers sell drugs to pharmacies. They are ultimately compensated by PBMs on behalf of insurance companies whose fiduciary obligation is to shareholders and to make more and more money."

Under the new legislation, PBMs must give at least 85% of rebates and discounts to consumers. Ciaccia contended the savings should add up to about $250 billion a year but a "good amount" of it is kept for profit by PBMs and insurance companies. Opponents argue the new law could cause premiums to rise.

The only way for the system to properly operate is for competition to regulate the market, Ciaccia said.

"When PBMs make more money, when list prices go up, we lose that necessary balance that the system is supposed to have," he explained. "And so, by realigning the incentives of PBMs, we hopefully put them in a place to actually lower prices rather than encourage them to be higher."

The new law goes into effect July 1 and mainly impacts prices for name brand drugs.


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Two new laws designed to protect California consumers take effect this year - cracking down on hard-to-cancel subscriptions and certain types of bank fees.

Assembly bill 2863 - which takes effect July 1 - will require subscription services to be as easy to cancel as they are to sign onto.

Robert Herrell - executive director of the Consumer Federation of California - said right now, canceling a recurring subscription can be a time-consuming nightmare.

"And that's not a bug in the system. That's a feature of those systems," said Herrell. "Many companies know that if they make it really hard for you to cancel, people will just either give up or forget about it, or whatever."

The new Click or Call to Cancel law also requires companies to remind customers once a year that the subscription is active.

The Federal Trade Commission just passed a similar national rule, which is already being challenged in court.

It's unclear whether the new Republican majority will challenge the regulation under the Congressional Review Act.

A second law - which took effect January 1 - bans state-chartered banks and credit unions from charging fees for non-sufficient funds, in cases where the card was rejected and the sale never went through.

Herrell noted that state data show these NSF fees, which can be up to $40 each, are very lucrative for financial institutions.

"A scary number of state-chartered credit unions are absolutely addicted to this revenue stream," said Herrell. "And what that means is that they are profiting directly off the backs of poor, working-class people, because that's what the data overwhelmingly shows about who's paying NSF."

More good news - starting in February more financial institutions must register with the state and submit data for monitoring.

These include companies that provide debt settlement, student debt relief, financing of private post-secondary education, and income-based cash advances.

More than three years after a federal law was passed requiring phone companies to install anti-robocall technology, fewer than half of those companies are in compliance.

The latest report on scam calls and texts finds that while robocalls are down roughly 17%, Americans still endure billions of these distractions every month.

Teresa Murray, consumer watchdog director for the Massachusetts Public Interest Research Group, said not only are robocalls annoying - they add unnecessary stress to everyday life.

"If you add up however many times that happens per day and how many times that happens per week," she said, "I guarantee you it's a measurable amount of time that you and I will never get back."

Murray said signing up for a Do Not Call Registry won't prevent all unwanted calls but will offer some protection. She encouraged people to contact their phone companies to demand they do more, and ensure that required robocall technology is installed across their carriers' entire system.

The report says as the number of intrusive phone calls declined, robotexts have more than tripled, and experts have said they are far more dangerous. While a person can avoid answering a call, most people see the beginning words of a text, which often include scary or urgent messaging, prompting them to click a risky link.

Murray said any unexpected texts, emails or calls requiring urgent payment are a serious red flag.

"The bad guys are always trying to get people to act right now - don't hang up, don't tell anybody - because they figure if they can get you to act immediately, then you'll perhaps make a poor choice because you're distracted," she said. "It just takes a few seconds to make a bad choice."

Murray advised people to never give out personal information, even if a solicitor appears to already have it. She said legitimate companies also don't ask for payments via gift cards or through apps such as Venmo or Zelle.

Massachusetts residents who believe they're the victim of a scam are encouraged to contact the Federal Trade Commission or the state attorney general's office.


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Starting this year, changes to California's "lemon law" will make it harder for consumers to get a refund or a replacement vehicle.

The changes mean instead of just taking the car to the dealer for repairs, you're now going to have to formally notify the manufacturer via email or certified mail and include your name, the vehicle ID number, a summary of the problems and a demand for a refund or replacement.

Rosemary Shahan, president of the nonprofit Consumers for Auto Reliability and Safety, said if you do not take the step, you forgo lemon-law protections.

"They're going to feel like they can ignore you and refuse to fix the problem," Shahan contended. "Or just do a real, cheap, temporary Band-Aid kind of fix until the warranty expires, and then they'll tell you how much they want you to pay for the repair out of your own pocket."

Gov. Gavin Newsom said he signed Assembly Bill 1755 reluctantly in order to cut down on lemon law lawsuits clogging the courts. Shahan noted lawmakers agreed to the changes only after General Motors and Ford threatened to support a ballot initiative capping attorneys fees in consumer lawsuits, something vigorously opposed by consumer attorneys, who are big political contributors.

The governor did negotiate a new bill, soon to be introduced, to allow manufacturers to opt in or out of the new program. Supporters of the changes, including General Motors, Ford and Stellantis, are expected to opt-in, while opponents such as Honda, Toyota and Tesla may decide to uphold the old protections.

Shahan noted the new lemon law said consumers who have negative equity, meaning they owe more on the lemon car than it is worth, can be forced to come up with the difference before the manufacturer will buy it back.

"The manufacturers will say, 'Oh, we'd be happy to buy back your lemon but first you have to come up with whatever the negative equity is before you can give us clear title to the car,'" Shahan asserted. "Most people can't afford to pay out of pocket, so they're going to be stuck with a lemon car."

The new lemon law also rescinds protections after six years, making longer warranties unenforceable, and consumers will now have only one year to file a claim, down from four.