Sen. Josh Hawley (R-MO) and Sen. Elizabeth Warren (D-MA) are leading a bipartisan charge to reform the healthcare system by introducing legislation aimed at breaking up large healthcare conglomerates. The proposed law would require companies like CVS Health, Cigna, and UnitedHealth to sell off their pharmacy divisions within three years.
The bill takes direct aim at pharmacy benefit managers (PBMs), which manage prescription drug benefits for employers and government programs. The three largest PBMs — CVS Caremark, Cigna’s Express Scripts, and UnitedHealth’s Optum Rx — control 80% of the market. Lawmakers argue this monopoly-like power drives up drug costs and stifles competition.
“The insurance companies are out of control,” Hawley wrote on X. “No more owning pharmacies. Start putting patients first.” Warren added that PBMs have exploited the system to “hike drug costs and eliminate independent pharmacies.”
Healthcare companies often bundle their PBM operations with retail pharmacy businesses, enabling them to steer patients toward their own pharmacies and mail-order services. Critics say this reduces competition and increases prices. CVS, for example, owns the nation’s largest pharmacy chain in addition to its PBM and health insurance operations.
The Pharmaceutical Care Management Association, representing PBMs, argued the legislation could reduce convenience and affordability for patients. CVS warned the bill might ultimately increase costs for consumers and benefit the pharmaceutical industry.
If passed, this legislation would be one of the most significant reforms to the healthcare system in decades. The bipartisan effort highlights growing dissatisfaction with the power held by healthcare conglomerates and the need to prioritize patients over profits.
