Congress moves to break up pharmacy-insurer conflicts in federal employee health plans

What it does

This bill prohibits the Office of Personnel Management from contracting with health insurance carriers for federal employee health plans if those carriers own or control pharmacies or pharmacy benefit managers (PBMs), and prohibits PBMs contracted by federal health plans from owning pharmacies. The goal is to eliminate conflicts of interest where a single company profits from both setting drug prices (as a PBM) and dispensing drugs (as a pharmacy owner), which can inflate costs for federal employees and taxpayers.

Why we flagged it

The bill's core mechanism is a structural prohibition on vertical integration (common ownership) between health insurers, PBMs, and pharmacies in the federal employee health plan market. It is a straightforward antitrust/conflict-of-interest measure, not a subsidy, deregulation, or commemorative act.

What the text implies

• The bill may force existing integrated carriers (e.g., UnitedHealth, Aetna/CVS) to divest pharmacy or PBM operations or exit the federal employee market entirely, potentially reducing plan options available to federal workers.
• Enforcement depends on OPM's contract-review capacity and willingness to challenge incumbent carriers; weak enforcement could render the prohibition symbolic.
• The definition of 'pharmacy benefit manager' is broad and includes third-party administrators and intermediaries, potentially capturing entities that do not self-identify as PBMs but perform PBM functions.
• The bill does not address PBM practices (rebate steering, formulary manipulation, prior authorization delays) directly; it only addresses ownership structure. Separated entities could still collude or coordinate pricing.
• Federal employee health plans may face higher administrative costs if forced to contract with separate PBMs and pharmacy networks, costs that could be passed to employees or the federal budget.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Federal employees and taxpayers benefit from reduced conflicts of interest in drug pricing and pharmacy networks. Eliminating vertical integration between PBMs and pharmacies removes incentives for PBMs to steer patients to affiliated pharmacies or inflate prices, potentially lowering out-of-pocket costs and reducing federal health plan premiums.

Who stands to gain

• Independent pharmacy networks and retail pharmacies (reduced competition from integrated PBM-owned c
• Federal employees (lower out-of-pocket drug costs if PBM conflicts are eliminated)
• Taxpayers (lower federal health plan premiums if drug costs decline)

Named in the bill

Office of Personnel Management (OPM), Federal Trade Commission (FTC), Department of Health and Human Services (HHS), Department of Justice (DOJ), State attorneys general, UnitedHealth Group (integrated carrier/PBM/pharmacy owner), CVS Health / Aetna (integrated carrier/PBM/pharmacy owner), Humana (integrated carrier/PBM), Pharmacy benefit managers (generic category), Retail and independent pharmacies

Where it stands

2 cosponsors: 1 Democrats, 1 Republicans.

• Jul 15, 2025 — Introduced · Congress.gov: “Introduced in House”
• Jul 15, 2025 — Referred to House Committee on Oversight and Government Reform · Congress.gov: “Referred to the House Committee on Oversight and Government Reform”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

6 lobbying clients named this bill on 8 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $25,042,990 in lobbying spend. A filing names 38 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 82% of bills with at least one filing.

Raja Krishnamoorthi, the sponsor, reported $763,350 in PAC receipts in the 2026 cycle.

• Chamber of Commerce of the U.S.A. — $16,950,000 on 1 filing
• CVS Health (and Subsidiaries) — $3,570,000 on 1 filing
• Pharmaceutical Care Management Association — $3,282,990 on 1 filing
• National Treasury Employees Union — $690,000 on 2 filings
• National Association of Letter Carriers — $280,000 on 2 filings

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.