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Byron Donalds: “We need to look at real reforms [for PBMs].”

Featuring: Byron Donalds, Republican | U.S. House, Florida, District 19

Health Care and Insurance Listening Session – Tampa, FL

Published February 21, 2026 | Video Starts at 50:10

And so while I think there was a time where PBMs were critical to how we were going to dispense drugs and find savings rate of individuals. I think that time probably is passing us. So We need to look at real reforms [for PBMs]. I know on Capitol Hill we're trying to find ways to perform PBMs and that's not done. And look, let's be clear about this. (50:10–50:14)

CLAIM

Asserts the need for reforms in the Pharmacy Benefit Managers system.

This is an excerpt from a raw transcript. The assertions have not been audited or verified. Tap the video to view the source footage and understand the context.

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Byron Donalds

“The Office of Insurance Regulation in Florida reported...none of the insurance companies in our state have requested a rate increase.”
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“If the losses in Florida go over $17 million, every insurance policy in our state can be assessed.”
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“Half of the state's operating systems, not half, maybe 30%, some of them still run on Dos Brock.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 40:32-40:42
“Kennedy Space Center over in Cape Canaveral, they did 160, 65 launches last year.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 45:22-45:30
“They're slated in about five years to do 400 launches.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 45:30-45:35
“The insurance market, property and casualty, has stabilized.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 04:32-04:36
“The auto insurance rates are actually coming down.”
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“We're going to keep the reforms that Governor DeSantis and the legislature put into place several years ago.”
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“We're actually going to see further rate reduction this year [in reinsurance].”
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“Florida is going to Lead the way on this. We are going to examine how we do Medicaid in our state.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 08:32-08:38
“We need to be far more efficient in delivering real choices and real interventions at key times [in healthcare].”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 12:54-13:03
“We want to drive far better health outcomes, not just using the whole healthcare system the way it's always been.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 13:25-13:32
“We are not going to expand Medicaid [in Florida].”
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“Medicaid expansion under Obamacare will create a major fiscal burden for the state of Florida.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 16:47-16:53
“Current Medicaid expansion calls for 90% payment for able-bodied adults between the ages of 18 and 54 by the federal government.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 16:56-17:14
“When they've expanded Medicaid, you actually get a flood of able-bodied adults out of the private health insurance market and into Medicaid.”
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“It actually crowds [the elderly, young with major issues, pregnant women] out when you expand Medicaid.”
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“If Florida doesn't catch it, we still pay for [Medicaid recipients who leave the state] here in Florida.”
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“We're going to give prompt answers instead of having to wait 60, 90, 120 days, it should be 30 days or less.”
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“Florida's government has to be just as responsive as Florida's businesses.”
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“We're going to do all the eligibility checks, all the fraud checks.”
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“Health care and Medicaid is going to be a major part of [Florida's government reforms and modernizations].”
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“Florida is going to have to completely re-examine mental health top to bottom.”
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“I think in Florida we do have to increase funding in mental health.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 24:29-24:34
“We should examine reopening some of the old state facilities with respect to mental health.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 24:33-24:52
“The number one thing that's pushed [property insurance rates] down has been tort reform in our state.”
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“Citizens announced, I think it was like an 8 to 10% rate reduction in citizens policies.”
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“The litigation costs are down because of tort reform that happened a couple of years ago in the legislature.”
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“The actuaries in our, the insurance companies, they need five years in order to do a full look back on what the true cost is to rate risk in…”
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“The reason why people choose to do business in Florida is because we're a common sense, pretty low regulation environment.”
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“Anti Semitism and any other form of bigotry, racism are simply not going to be tolerated [in Florida].”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 31:01-31:07
“Political leaders have a responsibility to establish moral clarity on [issues of bigotry].”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 32:19-32:24
“Infrastructure is critical for [Florida's] growth.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 34:30-34:30
“You have to have streamlined permitting and planning in these regions of our state.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 34:33-35:06
“It's actually quite rare for local government officials across jurisdictional lines to actually sit down and talk about these things.”
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“One of the government agencies said, well, we do our own design work. All right, well, how long is that going to take? Three years. Three…”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 36:24-36:38
“I commend the governor for actually opening up his moving Florida forward plan where he was taking some dollars to expedite key projects.”
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“We grew very, very fast over the last six years. Very fast. It was unexpected, but it happened.”
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“We have old legacy systems in state government that have not changed in a very long time.”
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“Governor DeSantis and Governor Scott, this is not their fault. They have made strides in trying to modernize the information systems of the…”
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“Government has a responsibility now to move at the speed of business.”
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“When we got rid of the film credits, I was in the legislature.”
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“Europeans are the ones who provide all the [film] credits.”
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“We have really chosen not to go down a broad based incentives route [for film industry].”
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“We have a geographic advantage because we can access both poles of the earth here in Florida.”
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“Finance is coming to our state. They're also going to Texas because New York and Illinois have plummeted.”
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“PBMs, when they were originally created, there was a reason... That simply doesn't really exist anymore.”
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“A lot of these PBMs, they have walked their ways into a very profitable industry and now they kind of don't want to let it go.”
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“It has to be real transparency. It has to be an open system where people can see the real costs and take advantage of them.”
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“This is why President Trump has been pushing so hard on most favored nation status. And I agree with him because with where we are in the…”
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“If we were going to make some adjustments to Medicaid and we didn't as Part of the DPP stuff that we're having to deal with here in Florida…”
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“The governor is beginning to look at that and try to deploy how some of those resources are going to be utilized in our state.”
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“Rural healthcare has to kind of resemble the concierge model per se, but it has to really kind of what was old is kind of new again.”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 51:58-52:10
“We believe that those dollars will help to facilitate that and actually help build out the internal infrastructure needed so you can have a…”
Health Care and Insurance Listening Session – Tampa, FL | Uploaded February 21, 2026 | 52:40-52:52
“Our standards in Florida need to be about young people mastering math, reading and writing when they graduate high school.”
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“We also need to help them identify what their natural strengths are in life. Maybe your natural strengths do not take you to the university…”
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“At the university level, what I think we need to start looking at is the economic viability of some of these degrees.”
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“Every child in our state should have an individual learning plan.”
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“We fund [education] not just to say we did it and it gives somebody a degree or a piece of paper that doesn't help them be successful in…”
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“What you're actually going to see with most favored nation, you're going to have a stabilizing cost, a true appreciation of the cost of…”
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“The United States and our people are subsidizing that cost for everybody else.”
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“Pharmaceutical companies are starting to really invest in technology to help squeeze the timeline in R&D.”
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“We've not had a dynamic free market system [in pharmaceuticals]. We've had a system of heavy subsidization, most of it coming from the…”
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