Sponsors (3)
The bill trades greater transparency and reduced conflicts in FEHB drug purchasing for the risk of fewer plan options, higher premiums or drug costs, and added administrative burden.
Federal employees enrolled in FEHB plans would face more transparent and competitive prescription drug procurement because the bill blocks vertical ownership ties between PBMs and pharmacies, potentially lowering markup and improving plan value.
Federal employees could experience fewer conflicts of interest in drug dispensing and pricing, because carriers/PBMs would be prohibited from vertical ties with pharmacies, which may improve clinical decision-making and patient safety.
Taxpayers retain multiple enforcement avenues because the bill preserves authority for the FTC, DOJ IG, HHS, and state attorneys general to pursue antitrust and consumer-protection actions.
Federal employees and taxpayers could see fewer FEHB plan options and higher premiums if the prohibition narrows the pool of qualified carriers and PBMs.
FEHB enrollees (including retirees) could face higher drug costs if reduced PBM participation weakens plans' negotiating leverage with drug manufacturers or pharmacy networks.
OPM and carriers would face increased administrative burden and complexity to verify indirect ownership/control relationships and ensure compliance, raising transaction costs and implementation friction.
Based on analysis of 2 sections of legislative text.
Bars OPM from contracting with FEHB carriers or PBMs that directly or indirectly own, operate, control, or direct a pharmacy, and restricts FEHB contracting with vertically integrated PBM-pharmacy arrangements.
Official title: To prohibit the common ownership pharmacy benefit managers and pharmacies that provide services under contracts with Federal health plans for Federal employees.
Introduced July 15, 2025 by S. Raja Krishnamoorthi · Last progress July 15, 2025
Prohibits the Office of Personnel Management (OPM) from contracting with FEHB-qualified carriers that directly or indirectly own, operate, control, or direct a pharmacy or a pharmacy benefit manager (PBM). Also bars OPM, FEHB carriers, and their contractors from contracting or subcontracting with PBMs that directly or indirectly own, operate, control, or direct a pharmacy. Defines key terms (health plan, person, pharmacy, PBM, qualified carrier), preserves enforcement authority of federal and state enforcement agencies, and does not appropriate new funds or change the underlying cited U.S. Code text.