Congressman Brad Schneider: The Next Step for the Main Street Pharmacy Access Act

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Hello and welcome to the Main Street Pharmacy Podcast.
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I'm your host, Kevin Woolahan, CEO at Workflow Services, and today I'm super excited to be joined by Congressman Brad Schneider, one of the key shepherds of the ECAPS legislation.
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Rev Schneider serves Illinois' 10th Congressional District, which is the North Suburbs of Chicago.
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He serves on the House Ways and Means Committee and is a co-sponsor of ECAPS, now known as the Main Street Pharmacy Access Act.
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Welcome to the show, Rev Schneider.
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It's great to have you.
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Thanks for having me.
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Where are you calling in from today?
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I'm in my office in Lincolnshire, Illinois.
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All right, back in the Midwest.
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Um could not be better timing to have you on the podcast.
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There's been a ton of activity around the Main Street Pharmacy Access Act.
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Um, as we know, it went through the House Ways and Means Committee and now it recently just had a successful hearing at Energy and Commerce.
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And so I'm interested to hear from you about that.
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I also, within the last hour, noticed the CBO report that was published this morning.
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So some interesting news there as well.
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But I would just love your take on where we're sitting with things, what's going on, like what's the status and what's the path forward.
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Yeah, let me uh talk about the status.
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The CBO report I'm aware of.
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I haven't had a chance to read it, but I am aware of it.
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So I I can talk about it.
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And uh even though I haven't read it, I'll I'll share some hypotheses.
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Uh what you know, the I know how they look at things and often look at things sideways.
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But uh the long and the short of it is we've been working on this for a long time.
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It predates me.
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Ron Kine from Wisconsin uh was working on this legislation.
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Uh when he um retired, I had the privilege of uh taking the lead and and trying to carry it across the finish line.
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Um, I represent Walgreens as headquartered in my district.
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Yeah, I know how important pharmacies are.
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Uh I know how important access to care is, and we need to do so much more to make uh uh uh keep care available, affordable, consistent, etc.
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Um and I I didn't even think of this, but uh uh Sunday I went to my local pharmacy, Walgreens, and got my uh flu and and COVID vaccine.
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Yeah I I had it a free hour, we looked online, there was an opening, and my wife and I went and got our shot.
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Um this is really important legislation.
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So we moved through the uh Ways and Means Committee.
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Uh it may be because I pestered uh Chairman Smith so much.
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Every time I saw him, I said we need to move this.
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And I want to thank uh Adrian Smith who was my partner, um, Jason Smith.
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But we had a constructive conversation uh in the committee and passed it forward.
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Uh it then uh we need to move it through the Energy and Commerce Committee.
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They have a slightly different approach.
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We have a one-step markup where the committee considers the bill, mayor propose uh amendments or not, and then votes whether or not to send it to uh the full floor, which we did.
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Uh on the energy and commerce committee, they have two steps.
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The working group passed out of that, and now it needs to go to the full committee for um a vote.
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Uh and hopefully we can get that done when we get back uh after the election in the lame duck.
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Um Congress has a way of making everything difficult.
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This should not be that difficult.
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I think there's there's uh we we have the broad support.
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Uh there are voices that are are opposing it because they have a stake uh contrary to uh pharmacists.
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But look, 89% of the country lives within five miles of a pharmacy.
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Right.
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Uh that's not the same, the same is not true for access to a physician or a uh uh a full uh fledged health care facility.
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Pharmacists see patients.
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I I visit my local pharmacy at least once a month.
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Uh maybe it's picking up a prescription for me or for my wife, or or maybe it's uh uh going in to replace lost reading glasses.
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Uh you're in the pharmacy far more than you see your doctor.
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You build that relationship, you have that trust.
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And uh we can deliver the care, pharmacists providing uh flu vaccines, COVID vaccines, whatever the case may be, at point of contact with uh working families, their parents, children, grandparents, with trust they they they really deserve.
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So um hopefully we can move this forward.
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So tons of uh uh great insight there.
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And I feel like you've been you've been uh watching our podcast and you're saying all the same things we're saying.
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I couldn't agree more about the value of access to care through the pharmacy.
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You mentioned getting your your vaccines at Walgreens.
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We have a very cool program that we also help Walgreens with, allowing people to get access to at-home colon cancer screening with Walgreens.
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They can see if they're eligible and make it super easy to order the Kolaguard test, and they can get that of their house.
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And Walgreens, it just has proved that the pharmacy can be an amazing access point and uh and a great front door um to care.
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Um, I will say uh Ron Kind is a friend of the podcast, he was one of our earlier guests, and um, we have some interesting history.
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I grew up in his district, and so he was the commencement speaker at my high school graduation.
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So it's he talked about kind of passing the baton to you on this legislation when he was on.
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So it's it's great to have you here.
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Um what happens next?
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You you mentioned hopefully getting it passed in the lame duck after the election.
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Is that scary?
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Are we in a different spot?
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I mean, I don't I am outside of government affairs and politics, but I don't know that I've ever seen legislation with the kind of bipartisan support this has.
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I mean, we've got the bipartisan support, but we have a broken Congress.
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And uh before we started the uh uh podcast, you and I were talking about skiing.
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Uh, I've been uh actually as much as anything to lighten up the mood in a conversation, but also express my frustration.
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Uh, I should today be talking to you from Washington.
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Uh, but votes have been canceled.
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Today is uh for 2026, the 23rd day of scheduled votes that were canceled.
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What I call tomorrow will be 24, 24 snow days without the snow.
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Yeah.
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And um I I can't say for certain what's going to happen after the election.
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Uh, and and this is just the dysfunction we're seeing in con in Congress.
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Uh, we need to get back to what is uh um conveniently called regular order.
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We just need to get back to folks sitting down, talking to each other, finding common ground, and moving legislation forward that helps the people we're elected to represent.
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And this bill, whether you call it the Main Street Pharmacy Act or ECAPS, uh, it is a bill that helps the people we're representing, makes it easier for them to get the care they want, need, and deserve.
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And uh so we need to move it forward.
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So I'm hopeful that when we come back after the election, irrespective of the outcome of the election, that will convince leadership.
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And it really is um uh well on the committee, uh Brett Guthrie and Frank Lonan, hopefully they'll move it.
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But then at uh at the end of the day, it's got to go to the floor with Leader Scalise and Speaker Johnson.
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That if we can bring this, I suspect we'll get overwhelming bipartisan support and move it through the House.
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And then you obviously match it with the Senate and send it to the uh president for a signature.
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Can you talk a little bit about what it takes mechanically to get it to the floor?
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Can it go by itself or does it need to be paired with something else, or do you see something else on the horizon that it might get paired with if that's the case?
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Yeah, the answer is all of those, all the above.
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Um, it can go by itself.
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Um part of the reason we've had these snow days without snow is uh Civics 101.
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A bill goes, anyone can introduce a bill, it goes to the committee of jurisdiction.
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In this case, our bill is going to the waste and beans committee and energy and commerce committee.
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Uh, and then it goes to the rules committee.
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Uh before we vote on a bill, we vote on the rule for the bill, which governs debate, amendments if there are any, et cetera.
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And the rules committee right now is so dysfunctional that they can't agree on what should go to the floor for a vote.
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So then there's option B, which is a suspension.
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Uh, you go, you don't go to the rules committee, but now instead of a simple majority, you need two-thirds uh uh of the vote to get that.
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I think we could do that.
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I think you could get two-thirds majority uh on this bill.
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Uh on the one hand, a heavier lift to get two-thirds.
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On the other hand, you don't have to go through the battle of breaking through the uh the rules committee.
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Uh the other option, as you touched on, is finding another vehicle that has to pass.
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And there are many vehicles that have to pass before the end of the year.
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We've got to fund the government.
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Um many of the uh folks who watch Washington have been uh talking about how strange it is to be at the end of September.
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Our fiscal year ends at midnight, uh September 30th, and and starts new one starts October 1st.
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And there's no um panic this year because we voted weeks ago to extend the deadline to December 11th.
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But we have to fund it before December 11th, or we'll we'll have a crisis.
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We have a defense authorization bill.
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We have to uh move that.
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There's a surface transportation bill.
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There may be other things that need to move.
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And if you put other pieces on it that build support, or you see it's moving and you can get your piece on it that are on a bill that already has support, maybe we can do that.
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Uh right now everything is is is up on in the in the air.
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We'll see what happens.
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Yeah, yeah.
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Well, I mean, I there's a lot of people out here that are watching it and have their fingers crossed.
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And so um, you know, I'm hopeful.
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Like I said, the kind of bipartisan support that's here seems remarkable in this day and age.
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And so hopefully it can break through some of those barriers.
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And it's good to know that there are several different possible paths that that could make it, and you know, thankful to have you there as a shepherd.
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So and I'll take any path.
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I mean, to be clear, I if um I'll work with anybody, I'll uh we just gotta find a way to move this forward.
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Yeah.
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So talk a little bit.
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You said you haven't had a chance to review the CBO report, it just came out.
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I uh took a quick look at it.
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I'm not an expert.
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There's some stuff that was pretty exciting to see in there.
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They recognize that there's a bunch of people that can't get access to testing today because just the limitations through traditional um, you know, traditional uh healthcare delivery settings.
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Um without uh speaking to exactly what it says, to me, it looks like there's some savings early and then maybe a little bit of cost later, but it definitely talks about the ability to serve more um citizens of the country.
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How should we think about the fact that there is a CBO report today?
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Is that an encouraging thing?
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I I think it's it's good to have a CBO report.
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It's a uh useful perspective, it's not the the be all end all.
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Uh again, just to qualify, I have not read it, but I know it says that there is a cost uh to this bill, uh uh relatively significant cost.
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I my challenge, and I said I I'll I'll I'll throw some hypotheses of of why they are going to have a different perspective uh than uh I do.
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They tend not to, on any bill, take the full picture.
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Okay, you you have what you're gonna spend, what you're gonna save.
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Um here's what I know.
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If I go to get my uh flu shot, as I did on Sunday, because I had a little window of time open, one hour, and I went, I got it.
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Uh, I'm not gonna have uh hopefully will not have a flu, or if I do, will not not be as bad this year.
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It means that I'm less likely to miss work.
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I don't have to miss work to go.
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Uh I'm I'm less likely to get so sick that I end up in a hospital.
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And uh, all of those are the decisions we make as an individual.
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I make as an individual, should I or should I not get a flu shot?
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Yeah.
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And in that calculus is the the risk of getting the flu, but also the challenge of going to get the shot.
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Having that the pharmacy makes it easier.
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Well, it's not about the one person, it's about the millions of people that might be getting uh their their flu shot.
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And if I spread it over the millions, the economic impact of lost time at work, lost time uh of caring for family members, the time spent in the hospital.
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Um the cost of the flu shot is far less than what it would cost me to have even one night in a hospital.
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That's right.
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And that doesn't get counted in all this together because the one night in the hospital doesn't come out of necessarily um uh government coffers if I have private insurance.
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And so uh we lose all that.
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Making it easier and making it more likely that people are going to get the care that they need makes it more likely that we're gonna spend less on emergency care, on hospital care, on everything else.
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So I have to read the report, but my my sense is that you know I I am confident that this makes sound economic sense to empower the pharmacists, the medical professionals who are in close contact, frequent contact with patients, with communities, um, it just makes all the sense in the world.
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So I I I will read it and and and report back next time with more uh detailed analysis.
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Can can you um share a little bit about is there is there some uh required um inclusion in the process of that report, or is it more just around additional information and and context for typically it's just additional information?
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Um you know uh if you think the report's gonna come back that we're going to save money, the proponents of the bill will ask for a CBL report.
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If you think it's gonna cost money, the opponents for a bill will ask for a CBL report.
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I think it's good to understand and get that information, whether it's gonna come back as a net savings or a net cost.
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So we can offset that and balance it against the other things that we're doing.
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So uh Lisa, I will read it.
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Uh, I think it's important to have it, but it's not the be all end all.
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Yeah.
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Um, is there you you you're very passionate about the bill and the the ability to access care through the pharmacy.
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Do you have any stories that you've heard over time or experience?
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I mean, you talked about getting the the vaccine yourself even recently, but any stories that you've heard, we've had a bunch of guests share stories about how access to care in the pharmacy has changed the direction of someone's life, frankly.
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Anything that's resonated with you through your time rep uh representing folks across the country?
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Uh not since lunch.
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So I had lunch with a I had lunch with a friend.
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Um uh he's gonna be 87 next month.
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And it's uh I hadn't seen him in a while, and how are you doing?
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What's going on?
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He um lost his wife uh last year and he was he was struggling with that.
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Um asked him, what are you doing today after after lunch?
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He was going to his local pharmacy to get his medicine and get a shot.
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But it was also he was going for that for the company, right?
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Right.
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There's there's more to it.
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Uh my I my district is mostly suburban, but I get into some uh rural areas.
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Yeah whether it's a um chain or a multi-generational local pharmacy, it doesn't matter.
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Yeah, the person behind that counter is is someone that people rely on for that information.
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Yeah, and you know, I've spoken with new parents who yeah, they're in that store more often than they're seeing their pediatrician.
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Yeah, and then they're asking for for uh you know those that uh you know, what do I do about this?
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Or my my kid has a a little bit of drainage.
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Like, well, yeah, that's all all normal stuff.
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Um yeah, so these are the things you were talking about.
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Kids, um my kids are gonna my youngest will turn 32 next month.
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It seems like yesterday for me, the fear and just overwhelming uh sense of awe and dread of being a new a new father.
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Yeah.
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And uh, you know, the the places you go, you know, you you've got an ear infection uh at the middle of the night.
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You're going to that pharmacy.
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Um and you're talking to the pharmacist and saying, you know, I I don't want to don't want to go to urgent care.
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They may not open.
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I don't want to go to the emergency room.
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What do I do?
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And they they're there to help you out.
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We've said back to the cost of things.
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And I I'm remembering back to uh you know um we lived in Deerfield at the time where Walgreens is headquartered.
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We had a 24-hour pharmacy.
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So I would be there late at night when my kids were little, um wondering what I should get, asking the pharmacist, and it saved a trip to the emergency room.
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Yep, saves money, or it said you should probably go to the doctor.
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The examples can I enlist on and on, whether it's uh a new parent, a senior citizen, or everyone in between.
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And I'll give you a great against a great example.
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We heard a story on this podcast a few months back.
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One of our guests was doing vaccinations, and she had a customer come in and was just in the middle of vaccination and said, What are you up to this weekend?
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And the customer said, Ah, probably not much.
00:17:53.519 --> 00:17:54.079
I'm not doing that.
00:17:54.160 --> 00:17:55.039
Well, what's going on?
00:17:55.119 --> 00:18:03.279
And they started talking, and she she realized she probably had a urinary tract infection and said, Hey, you need to go from here over to urgent care now.
00:18:03.519 --> 00:18:07.759
Otherwise, you're going to end up in the hospital or the emergency department, right?
00:18:07.839 --> 00:18:11.599
Which is unfortunately in her state, some states, pharmacies can treat UTIs.
00:18:11.839 --> 00:18:24.400
In this state, she couldn't, but it's about that connection you were talking about and the access and caught it early and surely saved whoever the insurance company was a ton of money by catching it early early and addressing it sooner.
00:18:24.559 --> 00:18:30.400
And that happened because that patient had access to talk to that caregiver at the pharmacy.
00:18:30.799 --> 00:18:35.839
It was the access and the comfort to respond to the question, what are you doing this weekend?
00:18:36.000 --> 00:18:36.079
Yeah.
00:18:36.240 --> 00:18:39.839
You know, we go through our our our daily life, we see people, hi, how are you?
00:18:40.000 --> 00:18:40.880
Fine, good, thank you.
00:18:41.119 --> 00:18:42.319
We keep on moving.
00:18:42.720 --> 00:18:51.440
When you're at that that counter talking to the pharmacist, if you know the person, if you have that relationship, it's more than the superficial hi, how are you?
00:18:51.680 --> 00:18:52.000
Yeah.
00:18:52.160 --> 00:18:55.759
There, and there's a great range of those pharmacies still across the country that are doing stuff.
00:18:55.839 --> 00:18:59.119
We were talking a little bit about Colorado before we started filming.
00:18:59.200 --> 00:19:02.960
I don't know if you've been to Salida in Colorado, but there's a not a long time, but yeah.
00:19:03.519 --> 00:19:04.640
Awesome pharmacy there.
00:19:04.720 --> 00:19:07.359
Shout out to one of our customers, Salida Pharmacy and Fountain.
00:19:07.440 --> 00:19:11.359
They have an old school like ice cream soda fountain, and it's just great.
00:19:11.440 --> 00:19:20.079
But they're kind of a cornerstone of access to that kind of care in the community, so much so that they do these drive-in movie nights with their ice cream a couple times the summer.
00:19:20.240 --> 00:19:24.319
But it's one of those places, like you said, the pharmacists there know the community.
00:19:24.400 --> 00:19:25.359
They have conversations.
00:19:25.519 --> 00:19:36.319
They're they're that first line of healthcare delivery and just the comfort and just familiarity and just the repeated nature that you're seeing someone in that role.
00:19:36.400 --> 00:19:41.279
There's so much ability for the pharmacist to truly improve and drive outcomes.
00:19:41.359 --> 00:19:47.119
And so I just really hope I hope that this legislation has one of those paths that works out here this year.
00:19:47.359 --> 00:19:49.359
We're gonna look for any path we can find.
00:19:49.599 --> 00:19:50.240
Yeah.
00:19:50.559 --> 00:19:53.519
Um, okay, I've loved the conversation.
00:19:53.680 --> 00:20:02.799
Any last thoughts on anything the listeners can be doing or folks in the community or in the pharmacy industry can be doing in the in the in the few months we've got left?
00:20:03.039 --> 00:20:06.880
Yeah, I mean, look, we are a government of by and for the people.
00:20:07.039 --> 00:20:19.200
So uh on this or any other issue that's important to folks, I tell people make sure you're talking to your representatives, make sure they know what what's important to you, uh, whether it's a a letter, a phone call, a personal visit.
00:20:19.359 --> 00:20:22.799
Uh those are always uh I think have have very high impact.
00:20:22.960 --> 00:20:24.480
We're gonna watch it closely.
00:20:24.640 --> 00:20:29.039
Uh last I saw the Senate's gonna wrap up and head head home.
00:20:29.200 --> 00:20:34.799
So uh Congress is is going to uh dim the lights between now and the election.
00:20:35.119 --> 00:20:43.200
My hope is that uh when we come back after the election, the lights will shine bright and we'll get a lot of work done and and uh I'm gonna keep working on this.
00:20:43.519 --> 00:20:46.000
Well, thank you so much for the good work you're doing on it.
00:20:46.079 --> 00:20:50.400
Um, we're all over here rooting, and I'm just a guy who records conversations on video here.
00:20:50.480 --> 00:20:56.559
But certainly, if there's anything I can do or or uh you know anyone else around our organization, let us know too.
00:20:56.720 --> 00:20:58.799
Thank you so much for spending the time with us today.
00:20:59.119 --> 00:20:59.440
Thank you.
00:20:59.599 --> 00:21:01.119
I enjoyed the conversation.