By Dave Ress

Democratic candidate for governor Abigail Spanberger wants to crack down on a range of insurer practices she says are keeping drug costs up, and hitting Virginians with abusive billing practices and scam coverage.

Stopping Wednesday at a community pharmacy in Mechanicsville, Spanberger said holding down the cost of medication is a priority but she stopped short of backing the a prescription drug board to cap drug prices. Democratic legislators have pushed the concept for two years and Gov. Glenn Youngkin has vetoed the measures.

But Spanberger weighed in on a corner of the insurance business that few Virginia politicians have ever mentioned: insurance policies that offer extremely limited and unnecessary coverage, such as cancer policies or credit insurance that step in when a disability or illness keeps individuals from working.

“People will think they’ve got coverage when they really don’t,” she told the Richmond Times-Dispatch.

Spanberger said health care is the reason she jumped into politics. She said she ran against then-Rep, Dave Brat, R-7th, in 2018, angered by his vote to repeal the Affordable Care Act.

Now, she said: “The No. 1 priority that Virginians share with me is the need to make everyday life more affordable. And it’s in these conversations that I routinely hear about the high cost of health care and prescription refills, stories of prescriptions left at the counter when they ring it up, and a family that’s making a choice between filling a prescription or other costs at home.”

If elected, she said she would push to crack down on pharmacy benefit managers, the firms that promise to manage drug costs for health insurance firms. They make money from the difference between what they pay for drugs and what they charge pharmacies when an insured patient presents a prescription for a pharmacy to fill.

“They’re the people who are inflating the cost of Virginia’s prescription drugs to turn profit,” she said.

“PBMs, the middlemen of the pharma industry, steer Virginians towards overpriced drugs at their own pharmacies, and as governor, I will ban this practice to make sure that Virginians can use the pharmacy of their choice,” she said.

Spanberger said cracking down on the sale of what she called scam coverage would be another priority.

“There are also, unfortunately, predators out there trying to scam Virginians with unnecessary coverage,” she said.

“These scams have gone on for far too long, and as governor, I will work to hold those bad actors accountable for ripping off Virginians, particularly when they are most vulnerable when it comes to their health,” she said.

Spanberger said another insurance effort will be to strictly enforce Virginia’s laws on surprise billing — the extra costs hitting Virginians when they, unknowingly, get care from providers who are not in an insurance company network. This has come up when emergency room doctors in a hospital are organized as a separate practice that’s not in a network, or when a provider forwards a sample to an out-of-network laboratory.

She said she wants to use the state’s own purchases of medications for employees and for the Medicaid program to negotiate lower costs of prescription medication and to encourage the state’s growing pharmaceutical sector to boost production of generic drugs.

But she said she still wants to find out more about how Prescription Drug Affordability Boards are working in other states, particularly in early innovators Colorado and Maryland, before deciding where to go with this approach.

The General Assembly approved measures in 2024 and this year that would have empowered a new board to cap prices of up to 12 medications. All Democrats in the House of Delegates and one Republican, Del. Ellen Campbell, R-Rockbridge, supported the 2025 measure, which picked up four GOP votes in the state Senate while two Democrats voted against the idea. Youngkin vetoed the 2024 and 2025 bills, saying they risk limiting patients’ access to medication.

Spanberger said she thinks a lot of good work has been done with such boards.

“But as we’re watching the implementation in other states, I want to make sure that whatever we might have as involvement in the future will be of best practices based on the successes or challenges that other states have faced,” she said.

In another part of the health care business, Spanberger said she wants the state to create a more transparent and easy-to-use tool that Virginians can use to compare the cost of care at different hospitals.