Mark Pinsley, the Lehigh County Controller and Democratic nominee for Pennsylvania Senate District 16, has made health care costs a focus of his office since he took over in 2020. The results: millions saved on prescriptions, money recovered from billing errors, and millions more in savings identified.
$3 million saved on prescriptions
In October 2022, Lehigh County Executive Phil Armstrong told 69 News the county was saving $3 million that year on its new prescription plan. (WFMZ, October 26, 2022) That plan exists because Pinsley pushed for it.
He explained the problem first. In November 2020, Pinsley published a plain-language paper on pharmacy benefit managers, the middlemen who run prescription plans. It showed how drug makers pay rebates to get their drugs favored, and how a pharmacy benefit manager can keep much of that money instead of passing it on to the employer. (NAS20-04)
Then he audited the county’s own plan. In January 2021, his office found the county overpaying for employee prescriptions. It was missing rebates, had a weak discount deal, and was paying more for some drugs than they would have cost with no insurance at all. The audit found more than $1.4 million in possible savings and recommended switching to a pharmacy benefit manager that charges based on what drugs actually cost. (Report 21-02)
He pushed for a rebid. The county had extended its Highmark contract in 2019, through 2022. In August 2020, with years left on that contract, Pinsley asked the county’s broker to run a competitive bid anyway.
The result. The county rebid the contract, and a new, more transparent provider, Capital Rx, took over in January 2022. The county’s 2024 audit found the cost per person on the plan fell 25%, from $2,050 to $1,530. (Report 24-25)
Money recovered
Audits don’t only find future savings. Sometimes they get money back.
- Health claims. His 2022 audit of the county’s medical claims led to at least $196,884.59 in recoveries, including $106,000 in stop-loss claims that had been billed in error. (Report 22-16)
- Jail health care. A 2025 audit of the county’s contract with PrimeCare Medical, which provides health care at the county jail, found billing discrepancies and recovered $46,884.59. PrimeCare confirmed the corrections in writing. (Report 25-07)
- The county nursing home. His office audited billing and collections at Cedarbrook three times until the problems were fixed. More: What is Mark Pinsley’s position on long-term care?
Even more health care savings identified
Pinsley’s office also found the county’s medical plan paying hospitals more than their own posted cash prices, and well above Medicare rates. It recommended paying based on Medicare rates instead, and identified about $4 million a year in potential savings. (Lehigh Valley Public Media · Report 22-16)
In 2025, his office asked two more independent providers what the county could save. They estimated $2.9 million and $3.4 million a year — against a county budget gap of nearly $4 million. (July 2025 memo) A follow-up that year found that, compared to national averages, the county had done well in minimizing costs, but as one of the county’s largest employment expenditures ($23.5 million in 2024), it was important not to leave potential savings on the table. (Report 25-24)
The July 2025 memo also recommended:
- Putting health plan administration out to competitive bid.
- Keeping the county’s insurance broker out of judging the bids, since brokers can get paid by insurers.
- Having bidders present in public, and publishing every proposal.
It also proposed that the county lead a health care buying group, so local small businesses and nonprofits could get the same rates the county gets.
Why it matters for Pennsylvania
Under Mark Pinsley’s leadership, the Controller’s office has produced a dozen audits and special reports on how to make health care more efficient and affordable for the residents and taxpayers of Lehigh County.
Pinsley says the same hidden pricing that cost one county millions is raising costs for families across Pennsylvania. As a state senator, he would push for:
- Real price transparency from hospitals, insurers, drug companies and pharmacy benefit managers.
- Caps on out-of-pocket costs for essential drugs like insulin.
- Using the state’s buying power to negotiate lower drug prices, the way large employers already do.
- Competitive bidding for public health plans, so counties, school districts and state agencies don’t just roll over contracts year after year.
- Open, conflict-free bidding. Insurance brokers who can be paid by insurers shouldn’t help choose the winner, and bids for public health plans should be presented and published in the open.
- Letting small businesses and nonprofits join public buying pools, so they can get the same health care rates as large public employers.
His full plan: What is Mark Pinsley’s plan to lower health care and prescription drug costs?
Every dollar he has found: How much money has Mark Pinsley found as Lehigh County Controller?
District 16 covers parts of Lehigh and Bucks counties. The general election is November 3, 2026.
