CVS warns bill will close 134 Tennessee pharmacies
CVS issued a warning saying Tennessee’s bill would jeopardize the closure of 134 pharmacies, including MinuteClinic, and affect more than 2,000 jobs.
A bipartisan group of lawmakers is renewing efforts to force some large pharmacy companies to spin off parts of their businesses and target drug price intermediaries.
This is a familiar bill to Tennesseans, as similar legislation has passed the state legislature and is awaiting Governor Bill Lee’s signature. CVS Health is threatening to close all 134 of its pharmacies in Tennessee as the bill takes aim at the pharmacy giant’s business model.
On May 13, Sen. Elizabeth Warren (D-Mass.) and Sen. Josh Hawley (R-Missouri) reintroduced the Exclusive Pre-Patient Act. Under the law, companies that own pharmacy benefit management companies or insurance companies would be prohibited from owning pharmacies.
The bill focuses on large health care companies that own pharmacies, as well as the insurance companies and pharmacy benefit managers (PBMs) that influence the prescription drugs Americans can get through their insurance plans and the costs of those drugs.
The big companies that own health insurance companies also own the nation’s three largest PBMs: CIGNA’s Express Scripts, UnitedHealth Group’s Optum RX, and CVS Health’s Caremark.
Warren and Hawley introduced the bill in December 2024, but the bill failed to advance.
Warren and Hawley’s bill, introduced Wednesday, would give PBMs, or companies that jointly own pharmacies with insurance companies, one year to sell their pharmacy operations. In the original version, companies had three years to sell part of their business.
The bill also specifies enforcement actions that the Federal Trade Commission, Department of Health and Human Services, Department of Justice, and state attorneys general can take against companies that violate the law.
For Warren and Hawley, the bill targets a narrower segment of the health care industry than the Great Care Breakup Act, which prohibits PBMs, health insurance companies and drug wholesalers from owning health care providers and pharmacies.
Warren said in a statement that she expects “PBM legislation will gain momentum as people begin to realize that they cannot lower health care costs without confronting corporate greed in the health care system,” adding that it is time to finally rein in the health care intermediaries that drive up drug prices and drive small pharmacies out of business.
Hawley said PBMs are “at the heart of a broken system that rewards middlemen while driving up costs for patients and crowding out independent pharmacies.”
He added that the bill would increase transparency and make health insurance more affordable for Americans.
Promoting dismantling PBMs gains bipartisan support
Rep. Diana Hershberger (R-Tenn.) and Rep. Jake Auchincloss (D-Mass.) introduced a sister version of the bill in the House.
Sens. John Fetterman (D-Pennsylvania) and Roger Marshall (R-Kansas) signed on as co-sponsors of the Senate bill. Rep. Greg Landsman, Democrat of Ohio, Rep. Buddy Carter, Republican of Georgia, Rep. Jerry Nadler, Democrat of New York, and Rep. Troy Neals, Republican of Texas, are co-sponsors of the House version.
Supporters of the bill cited national momentum toward PBM reform.
In 2025, a coalition of 39 state attorneys general asked Congress to pass legislation that would prevent companies from jointly owning pharmacies and PBMs. Also in 2025, the state of Arkansas passed a bill banning companies that own PBMs from operating retail pharmacies.
Tennessee Governor Lee received the bill passed by the state House and Senate on May 11th. He has 10 business days to sign the bill, veto it or allow it to pass without a signature.
CVS spokeswoman Amy Thibault said the company would close its Tennessee pharmacies if the bill becomes law, but that won’t happen right away because the bill doesn’t go into effect until July 2028. The company also said it was prepared to sue in federal court to block the bill.
Thibault said CVS does not take the Warren-Hawley Act into account, but the company provides a tailored platform to 185 million Americans.
“We support that and we really feel that our patients and members get value from it,” Thibault said.
Greg Lopez, a spokesman for the Pharmaceutical Care Management Association, a group representing pharmacy benefit managers, said the bill would make it more difficult for patients to navigate the complex system.
“One of the things that American patients and families dislike most about our health care system is that it is fragmented and complex. This bill would only make that problem worse, sending patients deeper into the maze of intermittent care,” Lopez said.
In February, Congress ended the partial shutdown of the federal government and passed a bill that included provisions addressing PBM transparency and business practices.
The law prohibited PBMs from collecting compensation based on drug prices, rebates, or discounts under Medicare Part D, according to KFF, a health policy nonprofit. Instead, PBMs will only be able to collect service fees starting in 2028.
