In February, the Trump administration launched TrumpRx.gov as a cornerstone initiative to lower prescription drug prices for American families. The platform offers unprecedented discounts ranging from 33% to 93% on essential medications. As President Trump said in his recent State of the Union address, “Americans who paid by far the highest prices of any nation anywhere in the world for prescription drugs will now pay the lowest price anywhere in the world” – all thanks to TrumpRx.
Unfortunately, Tennessee lawmakers are unwittingly sabotaging one of the most significant healthcare solutions from the Republican Party for decades. Senate Bill 2040 and House Bill 1959, misleadingly named the “Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act,” threaten to close countless pharmacies across our state. These are the very pharmacies that enable TrumpRx to deliver drug price discounts that Tennessee families need and deserve.
Here’s a critical fact that Tennessee legislators seem to not know: TrumpRx doesn’t sell drugs directly. It provides discount cards that patients present at retail pharmacies. Without accessible pharmacies that accept these cards, the entire program collapses.
For example, CVS announced that approximately 9,000 of its community pharmacies nationwide accept TrumpRx discount cards, making it the backbone of this historic program. Other major chains like Kroger and Costco are also participants in TrumpRx, as well as likely victims of pharmacy closures inflicted by the FAIR Rx Act.
This law would prohibit pharmacy benefit managers from owning pharmacies in Tennessee, forcing companies to either change their entire business model or forcibly sell of hundreds of pharmacy locations. CVS, for instance, has made clear that this bill will close all of their Tennessee pharmacies. This means Tennessee would lose pharmacies dispensing an estimated 15% to 25% of all prescriptions filled statewide.
Proponents claim independent pharmacies will simply absorb these patients. This is wishful thinking divorced from economic reality. Chain pharmacies fill an average of 138,000 prescriptions annually compared to 48,000 for independent pharmacies – nearly three times the volume. When Rite Aid faced bankruptcy in Pennsylvania, independent pharmacy owners told reporters they weren’t prepared to take on additional patients and simply wouldn’t accept them.
Due to understandable objections by the Tennessee Veteran population for the devastating effects this bill will have on the Veterans and military families that rely on consistent access to prescription drugs, the bill has been amended to exempt programs run by the VA, DoD, Indian Health Service, and OPM-contracted pharmacies. While this does nothing for the Veterans and military families that are on private insurance that rely on the pharmacies this bill will close, it is a clear recognition that this is bad policy.
Where is the carve out for the hard-working Tennessee family?
If Republicans are serious about following President Trump’s agenda to lower drug prices heading into the 2026 midterms, this bill must be stopped. TrumpRx is the flagship drug pricing initiative from the administration that conservatives should be championing for voters back home. President Trump called on Congress to enact The Great Healthcare Plan to codify TrumpRx savings. State legislation forcing pharmacy closures directly contradicts this vision. Republicans cannot allow state-level legislation to hand Democrats a talking point by undermining TrumpRx’s reach and effectiveness.
The bill’s sponsors, many of them Republicans, are inadvertently working against the President’s agenda and harming their own constituents’ access to affordable medications.
Arkansas passed similar legislation in 2025, only to be blocked by a federal judge who ruled the law unconstitutional. Tennessee is rushing toward the same legal quagmire, creating uncertainty for patients and the healthcare system while TrumpRx’s effectiveness hangs in limbo.
Tennessee conservatives must ask themselves: Do we want to advance President Trump’s signature healthcare achievement, or do we want to be the ones who undermined it? The FAIR Rx Act threatens to close pharmacies that enable arguably the most tangible solution to high drug costs we have seen in decades. That’s not conservative policy; it’s counterproductive government overreach that sabotages a winning solution.
Reject SB 2040 and HB 1959. Protect TrumpRx. Keep pharmacies open for Tennessee families.
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Aaron Gulbransen serves as CEO of The Tennessee Conservatives Coalition.
