The New Jersey Globe is continuing its series of legislator Q&As with Roy Freiman. Prior installments include Luanne Peterpaul, Dave Bailey Jr., Doug Steinhardt, Al Abdelaziz, Andrew Zwicker, Mike Inganamort, Cody Miller, and Chigozie Onyema.
Assemblyman Roy Freiman (D-Hillsborough) represents the 16th legislative district in the Assembly. First elected in 2017, Freiman serves as the chair of the Financial Institutions and Insurance Committee, and he is a member of the Budget Committee.
He worked at Prudential Financial for more than two decades. He succeeded Jack Ciattarelli in the Assembly, and though he’s won several close elections since 2017, his 2025 margins alongside Assemblywoman Mitchelle Drulis were the strongest of any Democrats in the history of the 16th district.
He is the primary Assembly sponsor of a bill reforming how pharmacy benefit managers, or PBMs, work in New Jersey. Gov. Mikie Sherrill has targeted PBMs as an opportunity to lower drug costs.
A list of Freiman’s floor and committee votes can be found here.
Click here to view a list of bills that Freiman has sponsored.
The following phone interview has been edited for clarity and length.
New Jersey Globe : I want to start with the bill that has been top of your mind and top of many minds lately. It’s the Patient and Provider Protection Act, and it touches on pharmacy benefit manager regulations. Can you talk about what that bill does and why it’s needed?
Roy Freiman: It reforms aspects of the pharmacy benefit managers. People might know of them as the “middlemen” between the insurance companies and the pharmacy.
Basically, this legislation has three different aspects associated with it. One of the aspects is how they get paid right now. For the most part, they get a percentage of the negotiated savings [on prescription drugs]. They go out and negotiate with the pharmaceutical manufacturers on behalf of their clients. Their clients are typically an employer or a health insurance plan, and they’ll go out and negotiate and share in the savings. That fundamentally sounds good, but it creates a conflict, because in order for the pharmacy benefit manager to make more money, the price of the drugs needs to go up, and if we want the price of drugs to come down, the pharmacy benefit managers would be making less money.
So they need to be disconnected and divested from the price of the medication, and so the bill says, “You can’t have your compensation tied to the price of the medication. Your compensation needs to be different, needs to be perhaps on a flat-fee basis or a volume-based basis of how many prescriptions you’re managing or the number of people that are in the network, but not based upon the price of the medications itself.”
Number two: On their relationship with their client — the employer or the health plan that they’re negotiating with and giving advice to — we are raising that to a fiduciary standard. When they’re giving advice, they should be working on their clients’ behalf, not their shareholders’ behalf. The three biggest PBMs are in the top 10 or top 15 of the largest companies in the United States. They have pressures to hit their own financial goals. That’s fine, but when they’re sitting and working and you hire them, they should be working on your behalf. So the bill creates a fiduciary standard.
The third one is — and this gets into the integration — as they’ve grown over the years, PBMs went from an adviser and a negotiator to firms that have their own insurance company. They originally started out saying, “Hey, I’m just going to be this middleman and help you negotiate and create what kind of prescription plan you should have attached to your health insurance.” Well, then they became a health insurance company unto themselves, and then they became a pharmacy that distributed the medications, and then they started to steer the most profitable medications to their own pharmacy network and distribution network, and then they decided how much the pharmacies get reimbursed when a pharmacy actually dispenses medication to patients.
And lo and behold, they dispense at a different rate to their own pharmacies than they do to the independent pharmacies. And this bill levels the playing field.
These are the three main pillars of this legislation, and it’s meant to reduce the costs of prescription drugs.
You and others refer to PBMs as “middlemen.” Is there a need for these middlemen at all? Will it ever be in the cards to just keep PBMs out of this process? How did they become so ingrained in this system?
PBMs are unique to the United States’ distribution system. Other countries do not have them. I’m not sure I have a crystal ball to answer the question of whether they will ever go away. I think they need to operate differently going forward.
I think that they came about because years ago, health insurance plans didn’t have prescription drugs as part of the health insurance, and then we needed to incorporate prescription medications into our health insurance. It was an area of expertise that didn’t exist with traditional employers, and they didn’t know where to go for the health insurance plan. That’s where these PBMs came to be. They became subject matter experts. They said, “Look, we can help you administer the prescription side of the insurance plan. As a matter of fact, we’ll help you figure out which one of these antibiotics makes sense, and we’ll go and we’ll help negotiate fair pricing from the large pharmaceutical companies.” That’s how it came about
As I mentioned before, three of the companies control 80% of all the medications that get dispensed in the United States, and they have insurance companies and pharmacies as part of their corporate structure, so they’re no longer just doing that level of work. I think the model is no longer delivering the benefit to the patients, the providers, or our healthcare systems.
This legislation isn’t unique. This came from reports from the Federal Trade Commission. This came from bipartisan reports from Washington, D.C. This came from academic research. So I can’t claim like we were the inventors here in New Jersey. We are just bringing this together, and we are showing political courage to move this forward.
How did you end up, out of all the topics that a legislator might focus on, as the figurehead for tackling PBM reform?
Well, it’s part of being chair of the Financial Institutions and Insurance Committee. It is a natural piece of legislation that would come through the committee. I have a background in financial services and insurance professionally, so I’m comfortable with the topic. And healthcare is a key component of affordability in New Jersey, so it fits into my theme of working on affordability.
You mentioned your work in the insurance industry. How did you go from that to being a Democratic assemblyman from Central Jersey?
I wish I had a pithy response to this.
This is exactly how I ended up in this job: Outside of being involved with student government in college, this is the first elected role I’ve had. I had 25 years with Prudential Financial, and I was transitioning out of that, and I was getting frustrated with leadership in government. I wrote an email to then-Assemblyman [Andrew] Zwicker, who I didn’t know at all, and I asked him how he got involved, because it was his first term. This was in 2016, and I didn’t know that he was looking for a running mate.
So it worked out perfectly.
At the time, it was him and Jack Ciattarelli in the seats, and then Jack Ciattarelli was looking to make his first run for governor, so it was an open seat, and we ended up flipping the seat.
Your first several elections were pretty competitive, but last year you won with a decent margin. How does it feel, after several years of close races, to win by the largest margin by Democrats in the history of the 16th district?
It felt great, and it felt earned. I still don’t think of us as anything other than a competitive district, because if you look at the registration and makeup of our district, I think it is a very balanced district.
I think we go from very blue to very red and everything in between, and I think that helps to make for better legislators, or more engaged legislators, which also means that somebody is angry with us at all times. So it’s a healthy challenge overall, but I think our margin of victory was because we’ve been working hard at doing the right thing. I don’t think for a minute that we should ever look at that margin and say, Okay, this is no longer competitive.
Beyond the PBM bill, when you head into the Statehouse on a given day, what are you focusing on? What are you hoping to fix for the future?
Affordability and making life easier. When I first joined, I wound up focusing on those primary things: How do you make it easier to do business or easier to get rid of the annoyances that New Jersey has? And that’s everything from trying to get some permits done, to paying your E-ZPass stuff, to, if you’re a business, getting through some of our red tape; and also affordability around our local taxes and property taxes.
You also get to that by helping to grow our businesses here in New Jersey and making New Jersey easier to do business with. Every time I meet with a business organization, I ask them how large their organization is and what it would take to double. What’s holding it back? Because I want to know. What are some things within our control that we can change?
On the PBM bill, it didn’t quite get past the finish line in the last session, but are you confident that it’ll be signed into law this year?
I’m more confident, yes. Some things are outside our control. I think that we are dealing with incredibly sophisticated organizations that don’t want to see it completed. These are not organizations that are going to say, “Okay, we surrender, you caught us.” And even if it does get done, we are affecting their business model. They’re going to be nimble, they’re going to change, they’re going to adjust. And we’re going to be at it all over again, because I’m not naive enough to think that we can just say it’s over and move on to something else.
I have no illusions that, all of a sudden, rainbows are going to appear over the state capitol and this problem is going to go away.