Pharmacy benefit manager legislation proposed by Pa. GOP legislators would harm Black and brown communities
If enacted, hundreds of brick-and-mortar and mail-order pharmacies could lose their licenses and be forced to shut down, writes Elena Rios, the president of the National Hispanic Health Foundation.
Pennsylvania’s Republican lawmakers are on the verge of deepening the state’s pharmacy access crisis — and Black and brown communities will pay the highest price.
Earlier this year, three Republican state senators announced intended legislation that purports to “protect” Pennsylvanians’ access to care. While not yet introduced, this proposed legislation would do the opposite, forcing the closure of chain pharmacies that are owned by companies that also own pharmacy benefit managers.
Verbatim, the announcement says the bill would, “prohibit PBMs from holding a pharmacy license in Pennsylvania.” If enacted, hundreds of brick-and-mortar and mail-order pharmacies could lose their licenses and be forced to shut down.
Closing pharmacies is not protection. It is a deliberate harm to vulnerable seniors, working families, and the communities that already struggle most to access care. Academic studies document that socioeconomic barriers can influence access to pharmacies.
Communities of color cannot absorb more neglect.
Pennsylvania is already deep in a pharmacy desert crisis. Since 2020, more than 1,100 independent and chain pharmacies have closed across the commonwealth — including Rite Aid, which filed for bankruptcy and permanently shuttered in 2025.
Residents in predominantly Black and brown neighborhoods in Philadelphia, Pittsburgh, and Allentown, as well as those in rural townships, already face long distances and real hardships just to fill a prescription.
The health stakes are high. Hispanic Pennsylvanians, in particular, experience higher risk factors for chronic disease, asthma, and multiple cancers than white residents. Managing chronic conditions requires consistent, affordable access to medication — and when that access is severed, patients split pills, skip doses, or abandon prescriptions entirely.
Medication adherence is already lower in minority communities. This legislation would make a serious problem catastrophic.
Proponents argue that independent pharmacies can fill the void. We’ve seen how that plays out. When Rite Aid collapsed, independent pharmacists reported being overwhelmed, creating waitlists and turning away patients on less profitable insurance plans. The chaos that followed will repeat — and intensify — if hundreds more pharmacies are shuttered at once.
This legislation also ignores legal reality. Arkansas passed a similar law that was immediately halted in federal court for violating the Commerce Clause and interfering with TRICARE, the healthcare program for veterans and military families. Tennessee faced fierce opposition from patient advocates and state Medicare officials.
Pennsylvania should avoid repeating these costly mistakes.
Pennsylvania’s Act 77, passed in 2024, already established meaningful oversight, transparency, and fairness in pharmacy benefit management — with the explicit goal of preventing pharmacy closures. These new proposals directly contradict that intent.
Communities of color cannot absorb more neglect. The National Hispanic Health Foundation strongly opposes this legislation and urges its immediate rejection.
Pennsylvania’s must instead pursue reforms that strengthen — not destroy — the healthcare lifelines our communities rely on.
Elena Rios is president of the National Hispanic Health Foundation, a leading national organization dedicated to transforming the healthcare system through leadership, research, and education to improve the health of Hispanics.