RAN May 20224

The Impact of Primary Elections on Nevada’s Democracy

By Bryan Wachter

AS WE EDGE CLOSER TO THIS YEAR’S PIVOTAL

Nevada primary election, a foundational truth stands unwavering: primary engagement is not merely an aspect of democracy but its very lifeblood. This engagement, encompassing the act of voting, debating, and deliberating on the future of our community, state, and nation, opens the door to a vibrant democratic process. It allows us to scrutinize past decisions, engage in meaningful debate, and propose visionary alternatives for our collective future.

At the heart of a thriving democracy is the principle of active participation. This year, Nevada’s primary election is a testament to the dynamic interplay of ideas and the essential role that primaries play in shaping our democratic landscape. Notably, the most significant races are unfolding among Democrats, a scenario that heralds the emergence of new voices and innovative

ideas. This influx of fresh perspectives is not just a mere occurrence but a crucial component of the democratic process, ensuring that the debate remains robust, diverse, and forward-looking.

The essence of primary engagement lies in its capacity to serve as a forum for debate. It’s within this arena that candidates can articulate their visions, policies, and solutions to the electorate. For the voters, it’s an opportunity to compare and contrast these ideas, to question and to seek

clarity. This vibrant exchange of viewpoints fosters a wellinformed electorate, capable of making decisions that reflect their collective aspirations and concerns.

Moreover, primaries offer a reflective lens through which we can evaluate past decisions. They prompt us to question: Have the promises made been fulfilled? Are the policies implemented beneficial to the broader community?

Bryan Wachter

Unpacking the Impact of Drug Rebates and PBMs on Prescription Costs

By Liz MacMenamin

IN THE COMPLEX WEB OF THE U.S. HEALTHCARE SYSTEM, PRESCRIPTION

drug rebates serve as a vital yet widely misunderstood mechanism within drug pricing. At the heart of this system are Pharmacy Benefit Managers (PBMs), entities that negotiate between drug manufacturers and health plans, ostensibly working to keep costs down for consumers. However, despite their intended role as cost savers, the operational

mechanics of PBMs and the rebate system they manage often lead to higher drug prices. This essay delves into the workings of prescription drug rebates, the essential function of PBMs, and highlights why reform in this area is crucial for reducing prescription drug costs, aiming to provide a comprehensive overview of a contentious aspect of healthcare economics. Despite their role in

Primary Elections

This introspection is vital, as it ensures accountability and encourages a culture of transparency within the political framework.

Looking forward, primaries serve as a crucible for forging alternatives for the future. They are the breeding ground for innovative solutions to the myriad challenges facing our society. In the quest for progress, it is essential that we remain open to exploring new pathways and embracing change. The primary election is the preliminary step in this journey, laying the groundwork for the policies and leadership that will steer our community towards a prosperous future.

Continued from page 1

This year, the Democratic side of the aisle in Nevada is abuzz with activity, signaling a vibrant contest of ideas and visions for the future. The emergence of numerous candidates vying for attention underscores the value of debate and the exchange of ideas in shaping the political landscape. Conversely, the Republican camp has demonstrated a unified front, underscoring their determination to maintain their positions and challenge the aspirations of their counterparts. This

dichotomy between the two major parties highlights the diverse strategies and philosophies at play, enriching the democratic process.

As Nevada stands on the brink of a crucial electoral decision, the importance of primary engagement cannot be overstated. It is the mechanism through which democracy breathes, grows, and evolves. By participating in this process, we not only exercise our right to vote but also contribute to the shaping of our society’s future. Approaching this electoral moment with eagerness and a sense of

and prescription drug rebates frequently result in increased costs for medications, underscoring the need for systematic reform to truly benefit consumers and the pharmacies caught in the middle.

THE ESSENCE OF PRESCRIPTION DRUG REBATES

Prescription drug rebates are post-sale discounts negotiated by

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duty not only strengthens our dedication to democratic values but also propels our community toward greater well-being and understanding. In essence, the Nevada primary election embodies the vibrant spirit of democracy, showcasing the indispensable role of engagement in fostering a responsive, accountable, and visionary governance structure. As we navigate this electoral season, let us remain mindful of the power of our participation and the impact it holds in charting the course of our democratic journey. ■

Liz MacMenamin facilitating cost savings, the operational dynamics of PBMs

Drug Rebates and PBMs

PBMs on behalf of health insurers and plan sponsors off the list price of medications. These rebates are supposed to incentivize PBMs to include certain drugs in their formularies—lists of drugs covered by health insurance plans—in a way that benefits patients financially. However, the real impact of these rebates on patient costs is murky at best, given the opacity of the negotiations and the disconnect between rebate savings and the prices patients pay at the pharmacy.

PBMS: A DOUBLEEDGED SWORD

Pharmacy Benefit Managers administrate prescription drug programs, playing a crucial intermediary role. They negotiate with drug manufacturers, manage formularies, and set payment levels for pharmacies. While they are positioned as entities that leverage their negotiating power for the benefit of consumers,

RENO POLICE CONTINUE TO COMBAT RISING RETAIL THEFT

Retail theft in Reno has surged, prompting businesses to implement stricter measures, including staff carrying whistles and enhanced surveillance. The Reno Police Department has responded with sting

the lack of transparency in their operations often leads to doubts about their effectiveness in reducing costs for the end consumer.

THE CASE FOR PBM REFORM

1. Incentives for Higher

List Prices: The current rebate system incentivizes drug manufacturers to set higher list prices, knowing that the after-rebate cost will remain favorable for PBMs and insurers but not necessarily for patients.

2. Opacity in Pricing:

The secretive nature of rebate negotiations between PBMs and manufacturers obscures the true cost savings, making it difficult to ensure that the benefits of these negotiations are passed on to patients.

3. Formulary Manipulation: PBMs exert considerable influence over which drugs are covered and their tier placements within formularies, decisions that can prioritize rebate revenue

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over patient needs and drug efficacy.

RAN’S COMMITMENT TO REFORM

Recognizing these challenges, the Retail Association of Nevada (RAN) is actively engaged in advocating for PBM reform. By working closely with legislators, RAN is championing proposals aimed at increasing transparency within the PBM industry, ensuring that savings from rebates are directly passed on to consumers, and protecting the vital role of pharmacies. These efforts are geared towards dismantling the perverse incentives and opaque practices that currently characterize the relationship between PBMs, drug manufacturers, and healthcare providers, with the ultimate goal of making prescription drugs more affordable and accessible for all.

Nevada News

operations to apprehend thieves and collaborates with businesses to bolster security. While police discourage confrontation, businesses are taking proactive steps to deter theft, signaling a community-wide effort to address the issue.

2 News Reno

LOMBARDO URGES BIDEN TO RELEASE FEDERAL LANDS FOR HOUSING DEVELOPMENT

Governor Joe Lombardo has penned a letter to President Joe Biden, urging him to release federal lands to the state to alleviate the

The complexities of prescription drug pricing, particularly the role of PBMs and the rebate system, are significant contributors to the high cost of medications in the United States. While PBMs play a critical role in the healthcare system, their current operational model presents challenges that often lead to higher costs for consumers. Reforming this system is essential for ensuring that the benefits of drug rebates are fully realized by patients, and RAN’s ongoing efforts to work with legislators on this front are a testament to the commitment to protect consumers and support pharmacies. By advocating for transparency, fairness, and consumer protection, RAN is at the forefront of the fight to make prescription drugs more affordable and the healthcare system more equitable. ■

housing crisis. Lombardo highlights the challenges faced by Nevada due to bureaucratic red tape in accessing federal lands and proposes updating or creating new statewide Resource Management Plans to expedite the process. He argues that

Unlocking Your Share of the $5.54 Billion Visa/Mastercard Settlement: What You Need to Know

RAN Staff Report

IT’S COMMON KNOWLEDGE THAT ACCEPTING VISA AND MASTERCARD

is a standard operating practice for running a business, and the credit card companies know it too. US Courts recently ruled that merchants were charged excessive fees to accept these cards because Visa and Mastercard, as well as their respective member banks, violated the antitrust laws. If your business accepted Visa and/or Mastercard between 2004 - 2019, you are eligible for a share of the $5.54 billion settlement.

Recognizing the significance of this settlement, RAN has joined forces with DCap Claims. Our goal is to streamline the claim process for our members to maximize your share of the settlement.

BACKGROUND:

In 2005 merchants and trade associations filed a class-action lawsuit against Visa, Mastercard and the banks that issue

payment cards citing price fixing and anti-competitive trade practices. Rather than continue legal proceedings, a settlement of $5.54 billion was approved by the presiding US District Court judge. Claims forms were mailed

HOW TO GET YOUR MONEY:

To participate in this settlement, you must file a valid claim before May 31, 2024. The amount you receive will depend on the interchange fees paid for transactions

RAN’s collaboration with DCap Claims is designed to simplify this process for you, ensuring you maximize your claim.

in December 2023 to the millions of businesses eligible to participate in the settlement. All claims must be submitted by May 31, 2024.

WHY IT MATTERS:

As a business that accepted Visa and Mastercard between 2004-2019, you are entitled to compensation under this settlement.

As we all know, credit card interchange fees are a significant cost of doing business. Because of anticompetitive trade practices, Visa and Mastercard overcharged your business.

Unless you previously optout of the settlement, this is your only opportunity to claim your share of the settlement.

with Visa and Mastercard cards between January 1, 2004, and January 25, 2019.

RAN’s collaboration with DCap Claims is designed to simplify this process for you, ensuring you maximize your claim. DCap specializes in claim filing and settlement support, helping businesses like yours navigate these waters. To kickstart this process, schedule a no-cost consultation with John Reighard of DCap Claims. Contact John directly at (707) 235-8636 or JReighard@ DCapClaims.com.

Disclaimer: On January 24th, 2019, the Court granted preliminary approval of the settlement filed on September 18th, 2018, for Rule 23(b)(3) Class Plaintiffs in this action. Most recently the Court announced claim forms are being delivered and will be online beginning December 1st, 2023. The deadline for claim submissions is May 31, 2024. No-cost assistance will be available from the Class Administrator and Class Counsel during the claims-filing period. There is no guarantee of amount of refund or distribution date of funds. Class members do not need to sign up with a third-party service in order to participate in any monetary relief. For additional information regarding the settlement, interested persons may visit the Court-approved website for this case at www. paymentcardsettlement. com/en. ■

2024 NEVADA PRIMARY SENATE REPUBLICANS

RACES TO RACES TO WATCH WATCH

The Governor’s Veto and Nevada’s Political Crossroads: preserving the Checks and Balances

RAN Staff Report

IN THE DYNAMIC AND OFTEN UNPREDICTABLE ARENA OF

Nevada politics, the upcoming election holds unprecedented importance, especially in terms of safeguarding the power of the governor’s veto. With the Nevada Senate and Assembly precariously balanced at razor-thin margins, the potential for a seismic shift in legislative power is palpable.

This election could enable Democrats to secure a super-majority in both houses, granting them the capacity to override any veto from the governor. This scenario not only underscores the critical nature of voter participation but also highlights the essential role of balance and bipartisan cooperation in fostering effective legislative outcomes.

The safeguarding of the governor’s veto power through this election is crucial for maintaining legislative balance and ensuring that bipartisan cooperation remains a cornerstone of Nevada’s political process. This balance is not merely a procedural formality but a

fundamental mechanism that encourages thorough scrutiny, debate, and compromise—elements that are essential for crafting legislation that truly reflects the diverse needs and opinions of Nevada’s populace.

THE IMPORTANCE OF THE GOVERNOR’S VETO

The governor’s veto serves as a vital check within the legislative process, ensuring that no single party or viewpoint can dominate without consideration of opposing perspectives. It compels lawmakers to engage in deeper discussions, consider broader implications, and, when necessary, work across the aisle to modify or improve proposed legislation. The potential for a veto encourages a more inclusive and comprehensive approach to lawmaking, which is particularly important in a state as diverse as Nevada.

The Impact of a SuperMajority

Should one party achieve a super-majority in both the Nevada Senate and Assembly, it could markedly diminish the effectiveness of the governor’s veto. This

shift would not only alter the dynamics of legislative negotiations but could also lead to a decrease in the incentive for bipartisan cooperation. When a single party has the power to unilaterally override the governor’s objections, there is less motivation to seek compromise or to consider alternative viewpoints, potentially leading to legislation that lacks the depth and resilience that comes from bipartisan input.

THE VALUE OF BIPARTISAN COOPERATION

History and experience have shown that the most durable and effective legislation often results from bipartisan efforts. When lawmakers from both sides of the aisle bring their perspectives, experiences, and ideas to the table, the resulting laws are more likely to address the needs and concerns of a broader segment of the population. Bipartisan cooperation enriches the legislative process, ensuring that policies are not only reflective of Nevada’s diverse population but also possess the flexibility and foresight necessary to stand the test of time.

THE ROLE OF VOTERS

The upcoming election represents a critical juncture for Nevada’s future. Voters have the power to decide the composition of the legislature and, consequently, the fate of the governor’s veto power. By participating in the electoral process, Nevadans can voice their preference for a balanced government that values and relies on bipartisan cooperation to address the state’s most pressing issues.

The significance of this election cannot be overstated. It presents an opportunity for Nevadans to reaffirm their commitment to a balanced legislative process, one that values the governor’s veto as a necessary check on power and champions bipartisan cooperation as the path to effective governance. As Nevada stands at this crossroads, the choices made by its electorate will shape the state’s legislative landscape for years to come, underscoring the enduring importance of balance, dialogue, and collaboration in the pursuit of the common good. ■

Election Watch: Key Issues Shaping Nevada’s Primary

RAN Staff Report

AS NEVADA APPROACHES ITS PRIMARY ELECTIONS,

the stakes are particularly high for the retail industry and the broader economy. The Silver State, renowned for its vibrant gaming and retail sectors, finds itself at a crossroads, with several key political issues poised to shape its future. Amidst an economic landscape bolstered by record-high wages, retail sales, and gaming revenue under President Biden’s administration, Nevada’s primary election carries implications for PBM reform, affordable housing, and the balance of power within the state legislature.

ECONOMIC PROSPERITY

Nevada’s economy has witnessed remarkable growth, buoyed by strategic policies and a resurgence in consumer confidence. Under the current administration, the state has seen recordhigh wages, propelling the spending power of Nevadans to new heights. Retail sales have similarly soared, reflecting a robust demand for goods and services, while gaming revenue has shattered

previous records, underscoring Nevada’s enduring appeal as a premier entertainment destination. This economic prosperity sets the backdrop against which the primary election unfolds, highlighting the significance of sustaining this growth trajectory.

THE CALL FOR PBM REFORM

Among the critical issues at the forefront is the reform of Pharmacy Benefit Managers (PBM). As intermediaries in the healthcare system, PBMs play a pivotal role in determining the cost and accessibility of prescription medications. The call for reform is driven by a demand for greater transparency and fairness, ensuring that Nevadans can access affordable medications without undue barriers. Retailers, particularly those with pharmacy operations, are closely monitoring this issue, understanding its potential impact on healthcare costs and consumer well-being.

ADDRESSING THE AFFORDABLE HOUSING CRISIS

VOTE

Affordable housing remains a pressing concern for Nevada, as rapid economic growth has outpaced the availability of affordable living options for many residents. The primary election is a critical juncture for addressing this challenge, with candidates proposing a variety of solutions to increase housing supply, provide financial assistance to renters and homeowners, and incentivize the development of affordable units. The retail industry, as a major employer and stakeholder in the community, is deeply invested in fostering sustainable growth that includes housing affordability for its workforce.

LEGISLATIVE SUPERMAJORITIES AND THEIR IMPACT

The composition of Nevada’s legislature— potentially shifting to supermajority status

— holds profound implications for policymaking and governance. Legislative supermajorities can streamline the enactment of legislation, affecting everything from tax policy to business regulations. While this can lead to more decisive action on key issues, it also emphasizes the importance of balanced representation to ensure that diverse viewpoints are considered in the legislative process.

As Nevadans head to the polls in June, the intersection of these political issues with the state’s economic health and social fabric is undeniable. The primary election offers an opportunity for Nevadans to shape the future direction of their state, making informed choices that will sustain economic prosperity, promote equitable access to healthcare and housing, and ensure a balanced legislative approach to governance. For the retail industry and the broader community, staying engaged and informed is more crucial than ever. ■

Important Information for SIG Members

Coates & Doran PLLC dba Sandstone Therapy

Nevada Travel Services Inc dba Convention Activities

Precision Armoy LLC dba Precision Armoy

The Kitchen LLC dba Sophia’s Gentlemen’s Club

TPV 55 LLC dba Vegas Prime

NRNSIG members who wish to register a negative vote on a new group member, please write NRNSIG at 575 S. Saliman Road, Carson City, NV 89701, indicating which member and the reason(s) for the negative vote.

May is Known as a Month of Transition!

If you live in the northern hemisphere, the fresh cold winds are gone, as are the rains of early spring. By the time May comes around, the spring flowers are blooming, birds are chirping, and life is starting to seem a little more joyful day by day!

NRS requires all existing members of a self-insured group to be notified of all new members. NRNSIG new members are listed below. Membership

www.RANNV.org.

National News

WALMART REDUCES SUPPLIER EMISSIONS WITH PROJECT GIGATON

Grocery Dive

HOME DEPOT BETS BIG ON PRO CUSTOMERS

Home Depot is acquiring SRS Distribution for $18.3 billion to strengthen its focus on professional contractors and builders as DIY spending declines. SRS, which will operate independently, has extensive resources with 760 warehouses and

Walmart’s Project Gigaton, aimed at cutting 1 billion metric tons of greenhouse gas emissions from its supply chain, exceeded expectations, showcasing the power of collaboration across over 100,000 suppliers. By offering education, financing, and recognition, Walmart incentivized participation, with over 5,900 suppliers joining the initiative. Through tools like sustainability-based supply chain finance and the Gigaton PPA program, Walmart facilitated emission reduction efforts, while recognition badges like “Giga Guru” status motivated suppliers. Walmart’s continued commitment to sustainability leadership signals broader industry shifts and emphasizes the importance of collective action in combating climate change.

Nevada News

releasing additional land, particularly in Clark County, is crucial for meeting housing and economic goals in the state. With housing costs soaring and land supply dwindling, Lombardo emphasizes the urgent need for action to address the housing shortage.

News 3 Las Vegas

LOMBARDO BACKS LEE’S LAND PROPOSAL

In a rare move, Governor Joe Lombardo endorsed

a proposal by Democratic Representative Susie Lee

Continued from page 3

aimed at streamlining the process for appraising public lands for potential development. Lombardo’s support for Lee’s Accelerating Appraisals and Conservation Efforts (AACE) Act marks his first endorsement of a federal Nevada Democrat’s bill since taking office in 2023. The bipartisan bill seeks to cut bureaucratic red tape and facilitate housing and infrastructure projects in Nevada by allowing the Department of Interior to contract with appraisers from any state. This endorsement

over 4,000 trucks, catering mainly to professionals in industries like roofing and landscaping. This acquisition, Home Depot’s largest, aims to capture more of the professional market, which is seen as crucial as consumer trends shift away from physical home improvements to experiences. The deal, to be financed with cash and debt, faces potential regulatory hurdles amid increasing scrutiny of large corporate mergers. CNN

WHOLE FOODS TO REMOVE AMAZON’S JUST WALK OUT TECH FROM STORES

Whole Foods Market has announced its decision

to remove Amazon’s Just Walk Out checkout system from its two stores that currently offer the technology, following the path taken by Amazon Fresh stores in the U.S. The specialty grocer plans to replace the system with more self-checkout stations and traditional registers, although the timing for these changes has not been specified. This move aligns with Amazon’s broader revamp strategy for its retail chains.

Grocery Dive

comes amidst tensions between Lombardo and Nevada Democrats over housing policies, offering Lee a notable bipartisan achievement as she seeks reelection.

Nevada

Independent

REPUBLICANS

CHALLENGE

NEVADA VOTER

REGISTRATION RATES

Republicans in Nevada have filed a lawsuit against Democratic Secretary of State Cisco Aguilar and local election officials, alleging inflated voter rolls violating federal law, with some counties showing more registered voters than adult citizens. The lawsuit demands compliance with the National Voter Registration Act and improved voter list maintenance. The state refutes the claims, citing unreliable data and federal restrictions on voter roll clean-up before elections, noting that inactive voters still retain the right to cast ballots.

Nevada Independent

Mary F. Lau President/CEO

Bryan Wachter Senior Vice President

Elizabeth MacMenamin Vice President of Government Affairs

Piper Brown Vice President, Finance and Administration

Megan Bedera Editor

Sue Arzillo, Alphabet Soup Inc. Newsletter Design & Layout

Retail Industry Continues to Be Largest Private-Sector Employer, According to New Report

National Retail Federation

THE RETAIL INDUSTRY SUPPORTED 55 MILLION full-time and part-time jobs in 2022, accounting for 26% of total U.S. employment, according to a new report released today by the National Retail Federation. The figures are up from 52 million jobs and 25% of total U.S. employment in 2018. Conducted by PwC, The Economic Contribution of the U.S. Retail Industry examines the direct, indirect and induced contribution of the

retail industry to the U.S. economy.

“The retail industry continues to expand in every way possible, from the number of jobs it supports to the number of retail businesses, and its total impact on GDP,” NRF President and CEO Matthew Shay said. “As the largest privatesector employer, American families and workers depend on a strong retail economy for continued growth and opportunity in communities large and small across the country.”

According to the report, the retail industry’s total labor income contribution was approximately $3 trillion, or 20% of total national labor income in 2022. The industry’s total gross domestic product (GDP) contribution was $5.3 trillion, accounting for 20.4% of U.S. GDP.

In terms of direct economic contribution, the report found that there were nearly 4.6 million retail establishments in 2022, which accounted for 11.1% of all business establishments in the country. Retailers also

directly provided 32.2 million jobs for American workers. While retailers can range from small, local businesses to global operations, the study found that the vast majority (98.6%) had fewer than 50 employees in 2022. These firms accounted for 40.1% of all retail jobs and 35.6% of total labor income in the retail industry. Those with 50 or more employees accounted for a significant portion of retail employment (59.9%) and labor income (64.4%). ■