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Marsha Blackburn — Republican U.S. Senator from Tennessee (official headshot)

Marsha Blackburn Voting Record & Scorecard | Center for Healthcare Affordability

US Senator from TN

Republican

2025 Score:

86.36%

Marsha Blackburn Scorecard Summary

Current rating
86%
Substantive votes
8 of 26 in 2025
District grade
B+
View Member History

Lifetime Ratings by Policy Category

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Sen. Marsha Blackburn (R-TN) earned a 86% Center for Healthcare Affordability score for 2025, showing strong alignment with healthcare reform and limited-government healthcare positions. Marsha Blackburn voted on 8 of the 26 substantive bills scored by Reform Healthcare in 2025. Highest category scores: Stagnating Advancements in Healthcare (100%), Skyrocketing Insurance Premiums (100%), and Exploding Government Spending (71%). Marsha Blackburn serves Tennessee in the U.S. Senate.

Healthcare Policy

Lawmaker Position

H.R. 1Senate 2025

Passing a "Big Beautiful Bill" with Multiple Pro-Freedom Healthcare Reforms.

+6
FOR
Affordable Healthcare
This reconciliation bill, the "One Big Beautiful Bill", strongly backed by President Donald Trump, contains a multitude of provisions that increase healthcare freedom. For example, the bill expands consumer-directed coverage: starting January 1, 2026, Obamacare Bronze and Catastrophic plans are treated as HSA-compatible, letting more families pair affordable coverage with tax-advantaged savings. The bill also tightened eligibility and accountability by excluding DACA recipients from exchange subsidies beginning plan year 2026, adding Medicaid "personal accountability" rules for the expansion population (80 hours/month, with rollout late 2026/early 2027), and limiting Essential Health Benefits by excluding gender transition procedures. Furthermore, the bill expanded the orphan drug exclusion so Medicare's "negotiation" regime doesn't penalize medicines that treat multiple rare diseases, and it avoided going further down the road of price controls like a most-favored-nation model. However, the bill missed the chance to deliver meaningful PBM reform.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
H.R. 1968Senate 2025

Enacting an HHS Funding Bill that Fuels Obamacare and Extends Runaway Medicaid Spending and Hospital Subsidies

-2
AGAINST
Affordable Healthcare
This bill, the “Full-Year Continuing Appropriations and Extensions Act, 2025,” keeps HHS funded for the rest of FY2025 on essentially last year’s levels (despite the DOGE cuts) and continues Obamacare-era healthcare policy on autopilot. Instead of using a must-pass funding deadline to demand reforms that lower costs and expand choice, this bill extends the same Washington-driven system that keeps patients trapped and taxpayers on the hook. Most notably, the bill does not rein in Medicaid’s runaway cost trajectory, and it further delays scheduled reductions to Medicaid hospital subsidies known as DSH payments. Those cuts were supposed to start tightening the belt, but the bill pushed them off again, protecting a crony flow of taxpayer dollars to politically powerful hospital systems. Even with all the talk about DOGE and cost cutting, this bill delivered no real reform, helped lock in higher federal healthcare spending, and kept deficit spending rolling. Note: lawmakers who opposed the bill merely because it didn't further hike spending were also recorded as opposing.
Oppose is the Pro-Healthcare Freedom Position for failing to reduce Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 1 (Amd. 2435)Senate 2025

Expanding Medicare Entitlements While Worsening the Inflation Reduction Act Drug Price Controls.

+5
FOR
Affordable Healthcare
The Sen. Bernie Sanders (D-VT) amendment #2435 to the "One Big Beautiful Bill", expands government control of healthcare by adding a major Medicare benefit expansion and escalating the Inflation Reduction Act drug pricing scheme. On benefits, it adds Medicare coverage for dental, vision, and hearing services beginning January 1, 2028, including routine exams and cleanings, major dental work, dentures, eyeglasses, and hearing aids. On drugs, it worsens the IRA's price control regime by nearly tripling the number of drugs Medicare is required to "negotiate", meaning more medicines are subjected to government extortion backed by massive excise tax style penalties. Secondly, it codifies a Most Favored Nation style price control scheme that pegs U.S. drug prices to a median price in other countries, importing foreign rationing and letting international bureaucracies effectively set what Americans can access. This is a direct attack on medical innovation and patient access by expanding coercive price caps across a far wider share of the drug market.
OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
H.R. 7148Senate 2025

Enacting Significant PBM Reform in the Consolidated Appropriations Act, 2026

+4
FOR
Affordable Healthcare
This bill, the “Consolidated Appropriations Act, 2026,” sponsored by Rep. Tom Cole (R OK), enacted targeted Pharmacy Benefit Manager reforms aimed at lowering prescription drug costs and improving transparency. It bars PBMs in Medicare Part D from tying their compensation to a drug’s list price, restricts spread pricing, and strengthens reporting and disclosure rules so plans, employers, and regulators can better see how PBMs are paid and how rebates and fees affect what patients and taxpayers ultimately spend. The bill largely helps correct the market distortion caused by Obamacare’s medical loss ratio provision. That mandate helped push insurers to merge with PBMs, and today three vertically integrated firms control roughly 80 percent of the market. This monopolistic structure has enabled PBM schemes that artificially inflate drug costs at the expense of taxpayers and patients. Support is the Pro Healthcare Freedom Position for reducing Obamacare Symptoms: Rapidly Rising Pharmaceutical Costs and Lower Innovation.
S. 3345Senate 2025

Lowering Drug Costs by Combating PBM Schemes Caused by Obamacare.

+7
FOR
Affordable Healthcare
This bill, the "PBM Price Transparency and Accountability Act", sponsored by Sen. Mike Crapo (R-ID) helps protect patients and taxpayers by implementing safeguards against Pharmacy Benefit Manager (PBM) schemes that have been fueled by Obamacare's market distortions. Under the bill, PBM compensation would be delinked from their negotiated rebates to disincentivize PBMs from promoting higher-priced medications. Additionally, PBMs would be required to pass Medicaid payments directly to pharmacies to ensure transparent drug costs for states and taxpayers. The bill largely helps correct the market distortion caused by Obamacare's medical loss ratio (MLR) provision. That mandate helped push insurers to merge with PBMs, and today three vertically integrated firms control roughly 80 percent of the market. This monopolistic structure has enabled PBM schemes that artificially inflate drug costs at the expense of taxpayers and patients.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 3385Senate 2025

Fueling the Out-of-Control Growth of Obamacare by Extending the Enhanced Subsidies through 2028 at a Cost of $350 Billion.

+10
FOR
Affordable Healthcare
This bill, the Lower Health Care Costs Act, introduced by Sen. Chuck Schumer (D-NY), would continue funding the "temporary" enhanced Obamacare subsidies for an additional three years, through the end of 2028. These COVID-era subsidy boosts, created in 2021 and later extended by the Inflation Reduction Act only through 2025, removed the 400 percent of the federal poverty level cap on eligibility, allowing situations in which families earning up to $600,000 can receive taxpayer-funded subsidies. The program is also rife with fraud and waste, and insurers have been enriched because the enhanced subsidies are effectively paid directly to them. Overall, these enhanced subsidies are projected to add roughly $350 billion to the national debt, on top of the enormous costs of the underlying Obamacare subsidy system.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
S. 3386Senate 2025

Extending the Enhanced Obamacare Subsidies Albeit via HSA Accounts.

-4
AGAINST
Affordable Healthcare
This bill, the "Health Care Freedom for Patients Act," sponsored by Sen. Mike Crapo (R-ID), would continue funding the "temporary" enhanced Obamacare subsidies, but it would channel them through health savings accounts (HSAs) instead of sending them directly to insurers. Enrollees earning below 700 percent of the federal poverty level would receive $1,000 if they are 18 to 49 years old and $1,500 if they are 50 to 64 years old. The prospective family of four would receive $5,000. These funds could be used only toward Obamacare Bronze and Catastrophic plans, which typically have higher deductibles and the least generous coverage. While this approach is better than the current enhanced subsidy scheme, which is ripe with waste and fraud and enriches insurers through direct taxpayer-funded payments, rejecting the bill would ensure the expanded Obamacare subsidies end entirely. Members who opposed the bill because they believed the subsidies did not go far enough, were recorded as opposing the pro-healthcare freedom position.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
S.C.R. 7 (Amd. 1207)Senate 2025

Worsening Government Cronyism by Creating a New Slush Fund to "End Price Gouging" on Prescription Drugs.

+6
FOR
Affordable Healthcare
The Sen. Jeff Merkley (D-OR) amendment #1207 to the budget bill, would establish a slush fund in the FY2025 budget for legislation aimed at "ending price gouging on prescription drugs." While framed as consumer protection, this is the familiar Washington talking point used to justify new federal price caps and expanded government control over drug pricing. In practice, amendments like this are designed to grease the skids for more aggressive Inflation Reduction Act style "negotiation" and other draconian price control policies that punish innovation and reduce long term access to new cures.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation.
S. 1186Senate 2025

Growing the Government Takeover of Healthcare by Expanding the IRA's Drug Rebate Mandates to Include the Private Sector.

Neutral
This bill, the "Lower Drug Costs for Families Act", sponsored by Sen. Catherine Cortez Masto (D-NV), worsens the draconian price controls imposed under the Inflation Reduction Act by exporting them beyond Medicare and into the private insurance market. The IRA created an inflation rebate scheme that punishes manufacturers when certain Medicare drug prices rise faster than inflation. This bill applies that same government penalty structure to drugs sold through private health insurance, extending Washington's coercive pricing regime into employer plans and commercial coverage, backed by civil monetary penalties. The bill also makes the price control regime even harsher by resetting the rebate base year from 2021 back to 2016, a change designed to inflate rebate liability and force larger payments to the government. While sold as consumer relief, these policies operate like a backdoor price cap that distorts markets, encourages higher launch prices, reduces discounts, and tightens access as companies try to manage rebate exposure. Over time, this approach undermines investment in new cures and pushes the system further toward centralized government control of medicine.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 1390Senate 2025

Expanding Rural Access to Care by Reversing Obamacare Restrictions on Physician Owned Hospitals.

Neutral
This bill, the "Physician Led and Rural Access to Quality Care Act", sponsored by Sen. James Lankford (R-OK), helps expand access to care in rural communities by rolling back Obamacare era restrictions that blocked new physician owned hospitals and prohibited existing facilities from expanding. The bill revises the federal physician self-referral rules so a covered rural hospital can qualify for an exemption, and it ends the blanket federal expansion prohibition that has locked in hospital monopolies and protected entrenched systems from competition. By allowing physician-led facilities to open and grow in rural areas, the bill promotes competition, increases local capacity, and gives patients more options instead of forcing communities to rely on consolidated hospital chains. This approach helps address the supply shortage and access crisis that has worsened under government-driven market distortions.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Higher Hospital and Provider Costs With Less Price Transparency.
S. 1506Senate 2025

Fully Socializing the Healthcare System through "Medicare for All".

Neutral
This bill, the "Medicare for All Act", sponsored by Sen. Bernie Sanders (D-VT), would fully socialize American healthcare by nationalizing health coverage into a single federal program run by HHS. It mandates universal coverage with automatic enrollment and wipes out real private coverage by prohibiting insurance that duplicates government benefits, leaving insurers only a narrow role for supplemental coverage. The bill imposes a one size fits all federal benefits mandate and shifts costs onto taxpayers by banning cost sharing like deductibles and copays for covered services. Its required benefits are sweeping, including long term care, dental and vision, and it explicitly includes abortion and gender affirming care coverage by taxpayers. It also terminates the Obamacare exchanges and consolidates major federal health programs into a centralized government run system, with the federal bureaucracy setting rules for providers and drug coverage, including a federal formulary.
OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
S. 1677Senate 2025

Worsening Obamacare Mandates by Forcing Coverage of Additional Conditions.

Neutral
This bill, the "Ensuring Lasting Smiles Act", sponsored by Sen. Tammy Baldwin (D-WI), expands Obamacare style federal benefit mandates by requiring group and individual health plans to cover outpatient and inpatient items and services for congenital anomalies or birth defects that affect the eyes, ears, teeth, mouth, or jaw. It compels plans to cover reconstructive treatment and broad related services deemed medically necessary by a treating physician, including adjunctive dental, orthodontic, and prosthodontic care from birth through completion of treatment, even when plans otherwise exclude these categories. This is another top down coverage mandate that overrides benefit design, drives higher premiums, and pushes insurers toward narrower networks and more utilization controls to manage costs. Instead of empowering patient choice and competition, it forces a one size fits all standard that grows federal control and worsens the Obamacare playbook of mandated benefits.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
S. 1818Senate 2025

Codifying a Socialist Drug Pricing Scheme Referred to as "Most-Favored-Nation".

Neutral
This bill, the "Prescription Drug Price Relief Act of 2025," sponsored by Sen. Bernie Sanders (D-VT), would codify a government price control scheme called "Most-Favored-Nation." It would peg U.S. drug prices to a "median price" in other countries, and if a manufacturer sells a drug above that level, the bill would effectively strip the company's intellectual property protections, allowing others to produce the drug. The bill is an effort to import foreign, government set pricing schemes that rely on heavy handed intervention and socialism to suppress prices. Like other price controls, this approach risks shortages and would seriously undermine medical innovation by scaring off investment and making it harder for manufacturers to recoup the massive costs of research and development, often over $1 billion to bring a drug to market.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 1836Senate 2025

Worsening the Scope of the Draconian Price Controls Imposed on Pharmaceuticals Under the Inflation Reduction Act.

Neutral
This bill, the "SMART Prices Act", sponsored by Sen. Amy Klobuchar (D-MN), expands the scope of the draconian price controls imposed under the Inflation Reduction Act. The IRA authorized Medicare to impose so called "maximum fair prices" on selected drugs and backed that scheme with massive excise tax style penalties that can escalate to coercive levels. The bill would more than triple the number of drugs Medicare is required to "negotiate", while also shortening the weight time following market approval that negotiation may begin (from up to 11 years, to just 3 years). This measure further threatens medical innovation under the IRA's extortion style approach. Such policies make investment harder to justify given the enormous cost of bringing a drug to market, often over $1 billion, plus the many failed candidates along the way. If the government steps in too early, imposes below market prices, and denies companies a fair chance to recover costs, fewer breakthroughs will be funded and patients will ultimately pay the price in delayed or lost cures.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 1847Senate 2025

Lowering Premiums by Expanding Association Health Plans and Limiting Obamacare Small Group Mandates.

Neutral
This bill, the "Association Health Plans Act", sponsored by Sen. Rand Paul (R-KY), helps restore choice and competition by letting small businesses and self-employed workers band together and be treated as one large employer plan under ERISA. It allows associations to offer coverage even if members are not in the same industry, so long as the group meets basic guardrails like real governance, at least two years of existence, and no health status discrimination. The bill also sets clearer rules for premiums by allowing an actuarially sound base premium built on pooled claims, while permitting employer level contribution rates to reflect each employer's risk profile. It includes protections that bar denying coverage based on a pre-existing condition and bans eligibility rules that discriminate based on health status. Overall, this reform pushes back on Obamacare's one-size fits all small group rules that drive up premiums and limit plan design flexibility for working families and job creators.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums
S. 2084Senate 2025

Expanding Medicare into a Bigger Government Run Benefit Program for Dental, Vision, and Hearing.

Neutral
This bill, the "Medicare Dental, Vision, and Hearing Benefit Act of 2025", sponsored by Sen. Angela Alsobrooks (D-MD), expands Medicare by adding new government run coverage for dental, vision, and hearing care. The bill would make Medicare cover routine dental cleanings and exams, basic and major dental services, emergency dental care, and dentures, plus routine eye exams, eyeglasses, and contact lenses, along with routine hearing exams and hearing aids. Instead of empowering patients through choice and competition, this bill represents a major entitlement expansion that grows the government footprint in healthcare and increases pressure for higher spending, higher taxes, and more top-down control over what services are covered and how providers are paid.
OPPOSE is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
S. 2286Senate 2025

Socializing Healthcare at the State Level through a Universal Coverage Waiver of Medicare, Medicaid, and Employer Plans.

Neutral
This bill, the "State Based Universal Health Care Act of 2025", sponsored by Sen. Ed Markey (D-MA), creates a new Obamacare waiver that lets states build a state-run universal health care system starting in 2026 by waiving major federal healthcare laws and funding streams. It explicitly allows waiver of key ACA coverage rules and subsidies, plus Medicare, Medicaid, CHIP, FEHBP, TRICARE, and even ERISA preemption, meaning states could pull employer coverage into a government designed system and redirect federal health dollars into a single state-controlled plan. The bill pushes centralized benefits mandates as a condition of approval, including required coverage for abortion, contraception, and gender affirming care, and it defines eligible "residents" to include aliens lawfully residing in the state, including those granted deferred action. It requires a plan to reach at least 95 percent coverage within five years and claims budget neutrality, but in reality it is a blueprint for expanding government control over healthcare decisions, costs, and coverage design at the state level.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.
S. 2302Senate 2025

Worsening Obamacare Style Mandates by Forcing Pharmacy Dispensing and Infringing Religious Freedom Protections.

Neutral
This bill, the "Access to Birth Control Act", sponsored by Sen. Cory Booker (D-NJ), creates a new federal mandate on pharmacies by imposing duties to provide FDA approved contraception and related medications. If a requested product is in stock, the pharmacy must provide it without delay. If it is not in stock but the pharmacy ordinarily carries it, the pharmacy must immediately tell the customer and either transfer the prescription or locate a nearby pharmacy that has it, or expedite an order. The bill goes further by policing pharmacy interactions and forcing compliance under threat of lawsuits and penalties, including a private right of action with punitive damages and attorney fees. It also explicitly blocks the Religious Freedom Restoration Act from being used as a defense, thus preventing pharmacists from refusing dispensing on conscience grounds. The bill further increases Washington control over the private operations of pharmacies.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Shrinking Competition and Fewer Quality Care Options
S. 2355Senate 2025

Restoring Market Forces to Healthcare by Strengthening "Price Transparency".

Neutral
This bill, the "Patients Deserve Price Tags Act", sponsored by Sen. Roger Marshall (R-KS), strengthens price transparency so patients can see real prices before they get care, instead of being trapped by hidden rates and surprise bills. The bill requires hospitals to publish all standard charges and negotiated prices in a clear format and expands the transparency framework to additional settings like imaging services and ambulatory surgery centers. The bill also forces insurers and health plans to give consumers clearer cost information and requires more meaningful explanation of benefits, including itemized descriptions and billing codes so patients can understand what was charged and what they owe. It further pushes back on health insurer and pharmacy benefit manager secrecy by protecting employer access to claims and payment data that is often buried.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Higher Hospital and Provider Costs With Less Price Transparency.
S. 2372Senate 2025

Worsening the Cronyism Fueled by Obamacare Within the 340B Program.

Neutral
This bill, the "340B PATIENTS Act of 2025", sponsored by Sen. Peter Welch (D-VT) would codify and expand the rampant abuse of the 340B drug pricing program that accelerated after Obamacare. The 340B program strong-arms drug manufacturers into providing steep discounts to "safety-net" providers as a condition of participating in Medicaid and other federal reimbursements. Under this bill, manufacturers would be forced to provide 340B pricing to contract pharmacies regardless of how or where a drug is dispensed, and the bill would impose draconian penalties for noncompliance. By letting hospitals route prescriptions through vast contract-pharmacy networks, the bill would supercharge the "buy low, bill high" model far beyond the walls of a true safety-net facility. This enrichment has exploded since Obamacare: there were 503 contract pharmacies in 2010, and now there are 34,840, with the scheme estimated to generate more than $53 billion in discounts. The predictable result is higher drug costs and less innovation for patients, all to enrich select hospital systems rather than the vulnerable people the program was supposedly meant to serve.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 2377Senate 2025

Worsening Obamacare Coverage Mandates by Forcing Plans to Cover Abortion.

Neutral
This bill, the "Equal Access to Abortion Coverage in Health Insurance Act of 2025" or the "EACH Act of 2025", sponsored by Sen. Tammy Duckworth (D-IL), would mandate abortion coverage across a wide range of federally run or taxpayer funded health programs, including Medicaid, CHIP, Medicare, TRICARE, the VA, the Indian Health Service, and the Federal Employees Health Benefits Program. The bill also blocks state and local governments from restricting abortion coverage in private health plans, and it repeals Obamacare's Section 1303, the ACA provision that allowed states to limit abortion coverage in exchange plans and imposed abortion funding segregation rules. It further asserts sweeping federal preemption by declaring the Act supersedes federal law and is not subject to the Religious Freedom Restoration Act.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
S. 276Senate 2025

Restoring Healthcare Freedom by Expanding HSAs and Empowering Direct Care.

Neutral
This bill, the "Personalized Care Act of 2025", sponsored by Sen. Ted Cruz (R-TX), expands health savings accounts by ending the Obamacare restriction that HSAs must be tied only to high-deductible plans. Instead, the bill makes far more Americans eligible to use HSAs, including those covered by typical group or individual coverage, short term plans, certain government coverage like Medicare and Medicaid, and participants in health care sharing ministries. The bill also increases HSA contribution limits, allows HSA funds to be used for more real-world expenses like insurance premiums and direct care fees. Finally, the bill recognizes direct care fees and health care sharing ministry payments as medical care for the unreimbursed medical expense deduction, reinforcing a patient centered path that supports direct doctor patient arrangements instead of funneling everyone through insurer and PBM middlemen.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums
S. 526Senate 2025

Lowering Drug Costs by Targeting Spread Pricing and PBM Schemes Caused by Obamacare.

Neutral
This bill, the "Pharmacy Benefit Manager Transparency Act of 2025", sponsored by Sen. Chuck Grassley (R IA), helps protect patients and taxpayers by implementing safeguards against Pharmacy Benefit Manager schemes that have been fueled by Obamacare market distortions. The bill cracks down on spread pricing by making it unlawful for PBMs to charge a health plan more than the PBM pays the pharmacy for ingredient costs or dispensing fees while keeping the difference. It also restricts certain clawbacks and strengthens transparency by expanding disclosures of PBM fees, price concessions, and manufacturer payments, as well as reporting on formulary changes and steering toward PBM owned pharmacies. The bill largely helps correct the market distortion caused by Obamacare's medical loss ratio (MLR) provision. That mandate helped push insurers to merge with PBMs, and today three vertically integrated firms control roughly 80 percent of the market. This monopolistic structure has enabled PBM schemes that artificially inflate drug costs at the expense of taxpayers and patients.
Support is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation
S. 529Senate 2025

Hiking Insurance Premiums by Imposing a Federal Cap on Prescription Drug Cost Sharing.

Neutral
This bill, the "Capping Prescription Costs Act of 2025", sponsored by Sen. Raphael Warnock (D-GA), imposes a new federal cap on what patients can be charged out of pocket for prescription drugs, not just in Obamacare plans but across employer coverage as well. Starting in plan year 2026, it caps annual prescription drug cost sharing at $2,000 per individual and $4,000 per family, with the cap increased in later years based on medical inflation. While marketed as relief, this measure merely worsens Obamacare's coverage mandates, shifting costs instead of fixing the real drivers of high drug prices. When government caps cost sharing, insurers and employers offset it through higher premiums, tighter formularies, more prior authorization, and less choice for patients.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Skyrocketing Insurance Premiums.
S. 641Senate 2025

Importing Foreign Price Controls by Allowing Prescription Drug Importation from Canada.

Neutral
This bill, the "Safe and Affordable Drugs from Canada Act of 2025", sponsored by Sen. Amy Klobuchar (D-MN), forces the FDA to create a pathway for individuals to import certain prescription drugs from Canada for personal use. It allows up to a 90-day supply purchased from an FDA approved Canadian pharmacy, filled with a valid US physician prescription, and matching an FDA approved drug's active ingredient and form. While marketed as relief, this approach effectively leans on Canada's government-controlled pricing system and imports the logic of foreign price caps into the US market. It does not fix the real drivers of high drug costs like PBM spread pricing and rebate games, and it risks undermining innovation by normalizing reliance on countries that free ride off American research and development. Over time, that means fewer breakthroughs and fewer competitive options for patients.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Rapidly Rising Pharmaceutical Costs and Lower Innovation.
S.J.Res. 84Senate 2025

Preserving Obamacare Subsidy Abuse by Blocking Marketplace Integrity Reforms.

Neutral
This joint resolution, sponsored by Sen. Mark Warner (D-VA), uses the Congressional Review Act to nullify the Trump Administration CMS's "Marketplace Integrity and Affordability" rule, a package of reforms aimed at reducing improper Obamacare enrollments and tightening subsidy accountability. The underlying rule strengthened income verification, tightened eligibility redeterminations, and targeted the broker and enrollment channel abuses that have fueled waste, fraud, and people being placed into coverage without real consent. The resolution would erase key guardrails that protect taxpayers and honest enrollees, including restoring looser rules that allowed more zero premium enrollments to be exploited, reversing policies that remove DACA recipients from subsidized exchange eligibility, and rolling back limits that prevented gender transition procedures from being treated as an Essential Health Benefit in ACA plans. Instead of fixing Obamacare's broken subsidy pipeline, this resolution protects it.
Oppose is the Pro-Healthcare Freedom Position for reducing Obamacare Symptoms:
Exploding Government Spending and Welfare Entrapment.

Frequently Asked Questions

What is Sen. Marsha Blackburn's voting record?

Sen. Marsha Blackburn (R-TN) earned a 86% Center for Healthcare Affordability score for 2025, showing strong alignment with healthcare reform and limited-government healthcare positions. Marsha Blackburn voted on 8 of the 26 substantive bills scored by Reform Healthcare in 2025. Highest category scores: Stagnating Advancements in Healthcare (100%), Skyrocketing Insurance Premiums (100%), and Exploding Government Spending (71%). Marsha Blackburn serves Tennessee in the U.S. Senate.

How aligned is Marsha Blackburn with healthcare reform and limited-government healthcare positions?

Marsha Blackburn earned a 86% Center for Healthcare Affordability score in 2025, showing strong alignment with healthcare reform and limited-government healthcare positions.

What is Marsha Blackburn's Reform Healthcare score?

Marsha Blackburn has a 86% Reform Healthcare score for 2025.

Where does Marsha Blackburn serve?

Sen. Marsha Blackburn (R-TN) serves Tennessee in the U.S. Senate as a Republican.

What issue categories does Marsha Blackburn score highest and lowest on?

Marsha Blackburn's strongest categories on the Center for Healthcare Affordability scorecard are Stagnating Advancements in Healthcare (100%) and Skyrocketing Insurance Premiums (100%). The lowest-scoring categories are Exploding Government Spending (71%) and Skyrocketing Insurance Premiums (100%).

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