CVS Health has issued a stark warning that it could close all 134 of its pharmacy locations across Tennessee if state lawmakers proceed with a controversial new bill. The proposed legislation, Senate Bill 2040, aims to prohibit the co-ownership of pharmacies and pharmacy benefit managers (PBMs), sparking a fierce debate over healthcare access and market competition.
Legislative Battle Over Pharmacy Ownership
The bill, sponsored by Tennessee State Senator Bobby Harshbarger, seeks to address what he describes as a conflict of interest in the healthcare system. PBMs act as intermediaries between retail pharmacies, health insurance companies, and drug manufacturers, negotiating drug prices on behalf of employers and insurers. Harshbarger argues that allowing PBMs to own pharmacies leads to patient steering, reduced consumer choice, and the squeezing out of local independent pharmacies.
"For too long, pharmacy benefit managers have been allowed to own or control pharmacies while also deciding which pharmacies patients can choose," Harshbarger stated in a Facebook post. "That conflict of interest leads to patient steering, reduced choice, and local pharmacies being squeezed out."
CVS Responds with Closure Threats
In response, CVS Health has vehemently opposed the bill, with spokesperson Amy Thibault branding it "bad for Tennessee." Thibault warned that if the Freedom, Access and Integrity in Registered Pharmacy (FAIR Rx) Act passes, it would force the closure of all 134 CVS pharmacies in the state, affecting more than 1.5 million patients and resulting in the loss of over 2,000 jobs. Additionally, 25 in-store MinuteClinic locations could be shuttered, though the company expressed a commitment to working with policymakers to find alternatives.
"The only thing this legislation does is force the closure of 134 CVS pharmacies," Thibault told USA Today. "It's bad for Tennessee, for the more than 1.5 million patients we serve and for the more than 2,000 colleagues who will lose good paying jobs."
Broader Context and Legal Precedents
This controversy unfolds against a backdrop of ongoing restructuring within CVS Health. The company confirmed to Newsweek that it has closed more than 1,100 pharmacy stores nationwide since 2022, part of a planned effort to optimize its network rather than a reaction to industry conditions. A spokesperson emphasized that the current footprint is designed to meet consumer needs in the right locations.
Senate Bill 2040 has already passed the Tennessee Senate Health and Welfare Committee, but its future remains uncertain due to legal challenges. A similar bill in Arkansas, Act 624 of 2025, was halted by U.S. District Judge Brian Miller, who ruled it likely violates the U.S. Constitution's Commerce Clause. This precedent could influence the Tennessee legislation's trajectory.
Political Support and Opposition
The Harshbarger family has been actively involved in PBM reform. Tennessee Representative Diana Harshbarger, Bobby's mother, introduced the Pharmacist Fight Back Act in December 2025 to prohibit PBMs from engaging in predatory behaviors. This highlights a growing political movement targeting PBM practices, though CVS and other stakeholders argue that such measures could have unintended consequences for healthcare accessibility.
As the debate intensifies, the potential impact on Tennessee's healthcare landscape is significant. Patients face the prospect of reduced pharmacy options, while employees risk job losses. The outcome of Senate Bill 2040 will likely set a precedent for other states considering similar regulations, making this a critical issue for the future of pharmacy services in the United States.
