A spokesman for a veterans advocacy group is warning that legislation under consideration in the Tennessee General Assembly could result in disabled veterans losing access to mail delivery services for prescription drugs, while also increasing their prices, unless state lawmakers amend the legislation to exclude those who served.
Nate Wisan, who serves as chief of staff for the Special Operations Association of America (SOAA) told The Tennessee Star on Friday that he has spoken to veterans in Tennessee who are concerned about Senate Bill (SB) 2040 by State Senator Bobby Harshbarger (R-Kingsport) and House Bill (HB) 1959 by State Representative Rick Scarbrough (R-Oak Ridge), which would prohibit pharmacy benefit managers (PBMs) from owning or controlling pharmacies in Tennessee.
PBMs are third-party companies that manage pharmacy benefits and negotiate drug prices between insurance providers and pharmacies.
The legislation would primarily impact consumers who receive their prescription medications via mail, including those veterans receiving prescriptions through Express Scripts, the PBM used by the U.S. Department of War health system that provides civilian health benefits to active and retired military, as well as their families, TRICARE.
Citing public reporting indicating there are nearly 400,000 veterans in the Volunteer State, including about 120,000 disabled veterans, Wisan told The Star that the legislation
“If this goes into effect, it’s not an instantaneous day one change, there is a phased approach. By the end of that phased approach, vets would no longer be able to get their mail order meds from these big companies,” said the SOAA spokesman. “For myself as a veteran, that’s a big deal. Our family personally uses Express Scripts to get our meds in the mail.”
For veterans living in rural parts of Tennessee, Wisan (pictured above) told The star the legislation could also mean the loss of nearby pharmacies with ties to PBM companies.
“Those pharmacies that are big chain probably will close down,” he said. “For those veterans who live far away from a pharmacy and get their stuff in the mail, they’re not gonna be able to get that anymore, they’re going to have to get in a vehicle and drive to a pharmacy and pick it up in person.”
Costs could also rise under the proposed legislation, according to the spokesman, who told The Star that large companies are able to build an “economy of scale” that results in lower prices for consumers.
“If they can provide these products cheaper to veterans because they’re big companies, if we remove their ability to to operate it all and all we have is local little pharmacies,” said the SOAA spokesman. “I’m personally a big fan of the little guy, but in this case, if only the little guys are the ones providing medication, it’s going to get more expensive.”
He also pointed to similar legislation that passed in Arkansas, where a U.S. District Court Judge appointed by former President George W. Bush issued a stay after a lawsuit was filed, finding it likely the plaintiffs will prove the law violates the U.S. Constitution’s Dormant Commerce Clause.
U.S. District Court Judge Brian S. Miller also found it likely that the Arkansas bill is preempted by federal law authorizing TRICARE for veterans.
“Tennessee and Arkansas are different district courts,” said Wisan, before adding that he, “would expect a very similar set of stays to be issued” if the legislation passes in Tennessee.
He told The Star, “You’re restricting commerce here. It’s not just our veteran population, that’s what I’m most informed on, so that’s what I can speak on, but there’s a lot of other concerns that kind of operate outside of my scope of understanding, such as commerce and businesses that will be impacted should people not be able to use or not receive their mail order meds.”
To avoid forcing veterans to reconsider their options, Wisan told The Star that SOAA recommended lawmakers amend the legislation with a carveout for military families.
“If you’re saying you can’t receive mail order meds, do a cutout and say veterans are still allowed to receive mail order meds,” he said, noting that the recommendation by SOAA did not show preference for a specific company.
He told The Star, “Just allow them the freedom to still receive their meds in the mail.”
Should the legislation pass, Wisan said that SOAA would be willing to support a Tennessee-based veterans organization to mount a legal challenge.
“We will happily partner with any Tennessee veterans group,” said the SOAA spokesman. “If there was a Tennessee veteran-based organization that takes that challenge and spearheads it, I’m sure we’d come alongside them.”
Before filing the legislation, Harshbarger said last year that PBMs were part of the reason for artificially high drug prices in Tennessee, and accused the companies of “squeezing the life out of the local community” due to their impact on small pharmacies.
At least five lawmakers involved with the effort appear to have ties to the industry, including Harshbarger, who is a pharmacist. Three co-sponsors of the State Senate version of the bill, Senators Ferrell Haile (R-Gallatin), Shane Reeves (R-Murfreesboro), and Lieutenant Governor Randy McNally, also have pharmaceutical backgrounds, while State Senator Joey Hensely (R-Hohenwald) is a physician.
The Senate Health and Welfare Committee is scheduled to consider SB 2040 on Wednesday.
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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].
Photo Nate Wisan” by The Grid Ecosystem and “Pharmacy” is by Harrison Keely CC4.0.
