Tennessee lawmakers are once again considering legislation that would expand government interference in the healthcare market by targeting pharmacy benefit managers.
First of all, I’m no fan of PBMs. There should be guardrails on them, and Tennessee has already put some on several times over the past decade. However, what I’m even more concerned about is the government telling a private company that it is not allowed to operate a business within a state. This anti-free market approach is exactly what Tennessee state Sen. Bobby Harshbarger is attempting to do by introducing a bill that would ban any PBM from also operating a pharmacy inside Tennessee.
Just think about that — your pharmacy down the street that’s been serving your family for decades could be forced to close if Sen. Harshbarger gets his way. Talk about the heavy hand of the government. And we thought the government’s closure of businesses during the pandemic was wild.
Supporters of such legislation will claim this levels the playing field. In reality, it’s another example of politicians picking winners and losers in the marketplace — a dangerous precedent that erodes consumer choice and undermines free enterprise. Especially when the sponsor himself is an independent pharmacist, which has to be a conflict of interest, right? How is that not the headline? And let’s not forget that his father, who is in the same business, was sentenced to 48 months in federal prison for secretly substituting cheaper Chinese drugs for kidney dialysis patients and forced to pay restitution of almost $1 million.
Telling the market who can and can’t operate is not how we handle such issues in a free market. Instead, if PBMs are operating pharmacies with higher prices, consumers will quite obviously go elsewhere. We don’t need the government establishing horrible precedents and dictating how companies run and who can operate them. Plain old competition and deregulation work just fine.
Banning PBMs from operating brick-and-mortar pharmacies is no different than telling Amazon it can’t sell its own products on its website, or forbidding a grocery store from offering a generic brand. That’s not “reform.” It is micromanagement of the private sector and big government controlling every decision from the top down. That’s not a can of worms we should open.
The irony is that Tennessee has already passed round after round of PBM regulations in recent years, including in 2025, 2024, 2023, 2022, 2021, and 2019. These measures were touted by the Tennessee Pharmacists Association as some of the strongest in the nation. Yet here we are again, with another push to tilt the market in favor of a politically connected group. It’s no secret that Sen. Harshbarger is a community pharmacist, and his proposal just so happens to benefit independent pharmacies while hobbling his competitors. That is not good policy. It’s protectionism. And I find it laughable to suggest that eliminating competition will ever benefit the consumer.
History shows where this leads. Arkansas tried to impose a similar ban just this year, only to have it blocked by the courts. The judge rightly noted that the law discriminated against out-of-state businesses without compelling justification. Louisiana, to its credit, rejected this same approach after recognizing it for what it was: an overreach of government power into private markets.
If Tennessee enacts this bill, it won’t just be unconstitutional — it will hurt patients. Fewer pharmacies mean fewer options, less convenience, and higher costs. Consumers, not politicians, should decide which pharmacy best meets their needs, just like we do every day, from pharmacies to grocery stores to car dealerships.
Republicans in Tennessee like to claim the mantle of limited government, but limited government doesn’t mean expanding bureaucratic authority every time one group of businesses complains about another. The role of government is to protect individual rights and uphold the rule of law, not to referee the marketplace on behalf of special interests.
WARREN AND HAWLEY JOIN FORCES FOR BILL THAT WOULD FORCE HEALTH INSURERS TO SELL OFF PHARMACIES
Instead of piling on more restrictions, lawmakers should focus on policies that encourage transparency, competition, and innovation. A true free-market system allows both small and large players to compete openly for customers, with the best service and prices winning out. That’s what drives costs down and raises quality — not government mandates.
Tennessee has an opportunity to stand firmly on the side of economic liberty. Lawmakers should reject this misguided bill and remember that the solution to high healthcare costs isn’t more government — it’s more freedom.
Hannah Cox is the cofounder and president of BASEDPolitics and owner of Athens Media.