Warren and Hawley revive bill to force CVS and rivals to divest pharmacies

Context Pharmacy benefit managers (PBMs) negotiate drug prices and decide which medications insurers cover. Lawmakers argue that when the same company owns a PBM and a pharmacy, it can steer patients to its own stores and raise costs. A bipartisan group of senators and representatives, backed by 39 state attorneys general, wants to break that link.

Key Facts Senator Elizabeth Warren said lowering health care costs requires tackling corporate greed and reining in health care middlemen who jack up drug costs and drive small pharmacies out of business. Senator Josh Hawley called PBMs the "center of a broken system" that rewards middlemen while pushing out independent pharmacies. CVS Health warned that if the bill becomes law, it would close all 134 of its Tennessee pharmacy locations, citing a threat to its business model; the company said closures would not be immediate because the law would not take effect until July 2028 and it may sue to block it. In 2025, 39 state attorneys general urged Congress to pass legislation preventing joint ownership of pharmacies and PBMs. The Patients Before Monopolies Act would give companies one year to divest pharmacy assets, with enforcement by the FTC, HHS, DOJ, and state attorneys general. A similar bill passed the Tennessee Legislature and awaits Governor Bill Lee’s signature.

What It Means Research shows a correlation between PBM ownership of pharmacies and higher drug prices. A 2023 cohort study of 1.2 million Medicare Part D beneficiaries found that patients whose prescriptions were managed by vertically integrated PBM‑pharmacy entities paid about 8% more for brand‑name drugs than those using separate entities; the study design was observational, so it cannot prove causation. If divestment occurs, independent pharmacies could gain market share, potentially lowering prices through increased competition, but patients might face temporary disruption as networks reconfigure. Practical takeaway: monitor your pharmacy’s pricing and availability over the next year; any changes in copays or store closures could stem from this legislation.

What to watch next Watch for Senate debate on the Patients Before Monopolies Act later this year and any legal challenges CVS may file in federal court.