Legislation submitted last week to the Tennessee General Assembly could leave veterans scrambling to replace their mail-delivered prescription medications, an advocacy group warned on Monday.
Senate Bill (SB) 2040 by State Senator Bobby Harshbarger (R-Kingsport) and House Bill (HB) 1959 by State Representative Rick Scarbrough (R-Oak Ridge) would ban pharmacy benefit managers (PBMs), the third-party companies that negotiate drug prices and manage pharmacy benefits, from owning or controlling pharmacies in Tennessee.
The legislation would also require annual ownership and control disclosures for pharmacies and empower the Board of Pharmacy to request corporate charts, contracts, and financial records for enforcement.
For PBMs deemed to be in violation, the legislation would authorize civil penalties of up to $10,000 per day.
When Bobby Harshbarger previewed his legislation last June, he told News5Â that PBMs are “why a lot of the drug prices are higher than where they should be,” and claimed the companies are “squeezing the life out of the local community,” by having insurance companies compensate local pharmacies for less than the cost of the prescription drugs they dispense.
Harshbarger and both of his parents, including U.S. Representative Diana Harshbarger (R-TN-01), are notably pharmacists. Three additional cosponsors of his bill, State Senators Ferrell Haile (R-Gallatin), Shane Reeves (R-Murfreesboro), and Lieutenant Governor Randy McNally, also have backgrounds in pharmacies. State Senator Joey Hensley (R-Hohenwald), another cosponsor, is a physician.
Contradicting the expertise of those backing the bill, the Special Operations Association of America (SOAA) argued on Monday that the legislation could impact thousands of veterans who rely on the PBM used by TRICARE, the military health system by the U.S. Department of War that provides civilian health benefits for active military personnel, veterans, and their families.
Noting that Express Scripts, a PBM, has provided mail-order prescription medications for TRICARE for over two decades, the advocacy group said Tennessee’s legislation could lead to disruptions for the business’ operations in Tennessee.
According to SOAA, should the legislation pass, “one of two things must happen: 1) Either Express Scripts shuts down its pharmacy operations,” in Tennessee, “eliminating a critical node in the TRICARE network; or 2) the Department of War is forced to reorganize its entire pharmacy program state-by-state.”
The advocacy group claimed, “This will destroy the national coordination that makes TRICARE cost-effective.”
SOAA also noted that similar legislation passed in Arkansas was recently blocked by U.S. District Court Judge Brian S. Miller, who was appointed by former President George W. Bush and confirmed to the bench in 2008.
While the Arkansas Advocate reported that Miller issued the temporary stay based partially on the language in Arkansas’ law that argued the bill was necessary to protect local businesses, which is absent from Tennessee’s bill, the judge also determined it likely violated the U.S. Constitution’s Dormant Commerce Clause, and was likely preempted by federal law, because it would interfere with the TRICARE military health program’s ability to contract with PBM-owned pharmacies that serve active duty military, veterans, and their families.
The legislation was introduced in the General Assembly last Thursday, but has yet to receive a first reading in the Senate or House. Neither version of the legislation contains a fiscal note to forecast additional costs to the state.
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Tom Pappert is a 2025 recipient of the Dao Prize and the lead reporter for The Tennessee Star. He also reports for the Star News Network. Follow Tom on X. Email tips to [email protected].
So if this happens, the prescriptions that my wife and I receive from Express Scripts will go from ZERO pay and free shipping to what? I can’t help but wonder if because TN politicians who were former pharmacists are against is and have a hidden addendum to line their pockets?