KNOXVILLE, Tenn. (Story courtesy of WVLT) -A bill that could change how prescription drugs are sold in Tennessee is generating significant debate at the state capitol and dividing lawmakers along very different lines of concern.
The pharmacy benefit manager bill would prohibit pharmacy benefit managers, known as PBMs, from owning pharmacies in Tennessee. Supporters say it would level the playing field for independent pharmacies and lower costs for consumers. But the bill is drawing scrutiny from lawmakers on both sides of the aisle — for reasons that have little to do with each other.
What the Bill Does
Pharmacy benefit managers act as middlemen between insurance companies and pharmacies. Critics say PBMs have shown preferential treatment to pharmacies they own while penalizing small, independent pharmacies and driving up costs for consumers.
A state audit by the Tennessee Department of Commerce and Insurance found significant discrepancies in how PBMs operate. The bill would ban PBMs from owning pharmacies in Tennessee, but the largest PBM operating in the state owns all CVS pharmacies, making the legislation one of the most closely watched bills of the session.
Massey: Jobs at Stake in Knoxville
Republican State Sen. Becky Duncan Massey, who chairs the Senate Transportation Committee and sits on the Senate Health Committee, was the only “no” vote when the bill came before the health committee — a position she said is virtually unprecedented in her 15 years in the legislature.
Her concern is not about prescription prices. It is about jobs.
“We have the large CVS distribution center here in Knoxville that distributes to 11 different states,” Massey said. “It’s 500 jobs there. And if the bill totally passes… they’d likely close that distribution center.”
Massey said she understands why the bill was brought forward and acknowledged the concerns about PBM practices but said she could not support legislation that puts hundreds of Knoxville jobs at risk. She also noted the bill will likely face a court challenge similar to a comparable Arkansas law.
“You go to the CVS app and it says, ‘Here, send this to your legislature,’” Massey said. “I think I got 100 of those emails today.”
Johnson: Patients Must Come First
Democratic State Rep. Gloria Johnson is approaching the bill from a different direction. Her focus is on the patient at the pharmacy counter — not the economic footprint of the companies involved.
“Voting no on the bill is going to make prices stay down for the person buying medication,” Johnson said. “I am going to do everything I can to keep those pharmaceutical costs low for the person going to the store to buy them.”
Johnson said the question for her is simple — who does the legislature protect?
“I don’t want parents or grandparents to go, ‘We can’t get your medication because we can’t afford it,’” she said.
A Session Defined by Division
The PBM debate is playing out against a backdrop of a deeply divided legislative session in Nashville.
Massey said the session has been dominated publicly by immigration bills and education voucher legislation, but argued that much of the legislature’s work goes unnoticed because it is not divisive. She pointed to legislation on AI protections for children, mental health coverage for volunteer firefighters, and foster care reforms as examples of bills that will make a real difference in people’s lives without generating headlines.
Her top priority this session is securing state funding for new mental health beds in East Tennessee. A state study found the region is 88 beds short of what is needed now and could be 150 beds short by 2050. Massey said every state lawmaker in the 24-county region signed a letter to the governor requesting funding in the upcoming supplemental budget, expected in early April.
“Every single state rep and state senator in this 24-county region signed that letter in support of it, which doesn’t happen to get everybody,” Massey said.
“We’re not cutting the cost of their groceries. We’re not making it easier for them to pay their utility bills or afford a home,” Johnson said.
Johnson is pushing legislation that would make hospitals and shelters safe spaces for immigrants, saying constituents are telling her they are skipping medical care out of fear. She is also sounding the alarm on the expected expansion of education vouchers, warning it would hurt rural counties most by pulling state funding away from public schools.
“The only way they got vouchers through was to do it in a special session in three days,” Johnson said. “They passed something in three days they could never pass.”
What’s Next
The full Senate and House votes on the PBM bill are still ahead. The Tennessee General Assembly is targeting mid-April to wrap up the session. Any bills that do not pass by the end of the two-year session are dead and would need to be reintroduced in the next legislative cycle.
