As legislative season begins, lawmakers should be careful about PBM ‘reform’

As state lawmakers begin to return to office this week, a number of issues will be clamoring for their attention. One of the most important — but perhaps overlooked due to its technical and less attention-grabbing nature — is pharmacy benefit manager reform.

Reform-minded leaders should work with PBMs, leveraging their market power to achieve lower costs for consumers.

Last year, Arkansas became the first state in the nation to ban PBMs, and other states heavily regulated the industry. These efforts are expected to continue in 2026, even as courts raise constitutional questions about the Arkansas law and regulations in Iowa.

I’m a health care broker, so I know PBMs pretty well. They’re easy targets because of the complex process by which they work, as well as the