Washington, D.C. — Today, Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) announced the Patients Before Monopolies Act, a groundbreaking bipartisan bill that will force health insurers and pharmacy benefit managers (PBMs) to divest their pharmacy businesses within three years. The bill aims to eliminate the structural conflicts of interest that have driven independent pharmacies out of business, inflated drug prices, and harmed patient care. Representatives Diana Harshbarger (R-TN) and Jake Auchincloss (D-MA) will introduce a companion bill in the U.S. House of Representatives. In response, the American Economic Liberties Project released the following statement endorsing the bill.

“Giant PBMs and insurers owning their own pharmacies have weaponized their power to crush competition, driving independent pharmacies to the brink and reducing access to care for millions of patients,” said Morgan Harper, Director of Policy and Advocacy at the American Economic Liberties Project. “The Patients Before Monopolies (PBM) Act addresses the root cause of this problem—consolidated market power—by eliminating the inherent conflicts of interest within the big three PBM business model. We are thrilled to see Sen. Warren and Sen. Hawley lead this bipartisan effort to lower drug costs, protect independent retail pharmacies, and improve patient access to care.”

Over the past decade, pharmacy benefit managers (PBMs) have transformed into powerful, vertically-integrated conglomerates that control nearly every step of the prescription drug process. By owning both PBMs and massive pharmacy chains, the largest health insurers—CVS/Aetna, Cigna, and United Healthcare—have rigged the drug delivery system to sideline independent pharmacies, limit patient choice, and inflate costs. This consolidation has shuttered thousands of independent pharmacies across the country, particularly in underserved areas, further eroding trust in a system already under strain.

The Patients Before Monopolies Act will:

• Prohibit any parent company of a PBM or insurer from owning a pharmacy business.
• Require violators to divest their pharmacy businesses within three years.
• Empower the FTC, DOJ, HHS, and state attorneys general to enforce divestitures and recover ill-gotten gains.
• Ensure divestitures are reviewed to protect competition and the public interest.

The need for reform has become even more urgent following renewed scrutiny of consolidated healthcare systems after the UnitedHealthcare tragedy. By addressing the core structural conflicts in the PBM-insurer model, this legislation will restore competition, lower costs, and prioritize patient care over corporate profit. The legislation is consistent with Economic Liberties’ recent calls for structural separation in the healthcare market.

Read Economic Liberties oped in The Hill, “Too big to care: It is time for a Glass-Steagall Act for health care,” here.

Learn more about Economic Liberties here. 

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The American Economic Liberties Project works to ensure America’s system of commerce is structured to advance, rather than undermine, economic liberty, fair commerce, and a secure, inclusive democracy. Economic Liberties believes true economic liberty means entrepreneurs and businesses large and small succeed on the merits of their ideas and hard work; commerce empowers consumers, workers, farmers, and engineers instead of subjecting them to discrimination and abuse from financiers and monopolists; foreign trade arrangements support domestic security and democracy; and wealth is broadly distributed to support equitable political power.