The proposal would allow the Maryland Prescription Drug Affordability Board to adopt a federal “Maximum Fair Price” as an upper payment limit for a drug without repeating the board’s full cost-review process. The limits could apply to people outside Medicare, though the board’s current authority covers state health plans, including coverage for state employees and incarcerated people.

The Maryland Healthcare for All Coalition, which is promoting the bill, said 29 Senate candidates and 98 House candidates have indicated support. Of those, 26 Senate supporters and 79 House supporters are incumbents. A typical bill needs 24 votes in the Senate and 71 in the House to pass.

Coalition president Vincent DeMarco said the candidate responses and Moore’s backing put supporters in a strong position. Del. Jennifer White Holland, a Baltimore County Democrat expected to sponsor the bill in the House, said high drug prices force some families to skip or ration medication.

“Whether it’s at the pharmacy counter … through our insurance premiums or with our taxpayer dollars, we all pay the high cost of prescription drugs,” White Holland said.

The measure would cover 25 drugs whose prices have already been negotiated by federal officials, 15 currently under negotiation and any drugs with federally negotiated prices in the future. Moore said the state could avoid months of review and potentially save tens of millions of dollars annually.

The state board’s existing process requires staff to gather data and consult drug manufacturers before members determine whether a drug presents an affordability challenge and consider ways to reduce its cost. The board has said future reviews may move more smoothly now that the process is established, but supporters argue that using federal negotiations could save additional time.

The board has so far selected Jardiance, a Type 2 diabetes medication, and Ozempic, used to treat diabetes and also prescribed for weight loss, for upper payment limits based on Medicare’s negotiated prices. Those limits are scheduled to take effect in January 2027. The state estimates the Jardiance limit could save about $320,000 a year for its health plan, with potential savings of $9 million to $16 million if applied across Maryland health plans. For Ozempic, projected savings range from $5.8 million for the state plan to $113 million to $165 million if broadened.

Maryland’s drug board was created by a 2019 law but took years to begin reviewing medications. The General Assembly expanded its potential authority to private insurance in a 2025 law, but that expansion will not take effect until a year after the board sets limits on two drugs under its current authority. With the Jardiance and Ozempic limits taking effect in 2027, broader authority is not expected before 2028.

Pharmaceutical manufacturers and some patient advocates, including advocates for people with rare diseases, oppose the proposal. They argue state price limits could threaten access to medicines and question whether the board’s actions will reduce patients’ out-of-pocket costs. PhRMA spokesman Will May said capped prices could make pharmacies, hospitals or physicians unable to obtain some drugs, and argued that government price-setting can limit access to new treatments.

Since the board was established, it has not yet lowered the price of a prescription drug in Maryland. DeMarco said the coalition plans to estimate potential savings across the 25 drugs with federally negotiated prices, and expects the total could reach hundreds of millions of dollars or more.