As someone who has worked in health care policy and calls Louisiana home, I know firsthand the challenges our families face to get and afford the medicines they need. That’s why I’m troubled to hear that there’s talk in Baton Rouge about reviving legislation that would ban Pharmacy Benefit Managers (PBMs) from owning pharmacies in our state, similar to the law recently blocked in Arkansas.
This kind of ban would be disastrous for Louisiana families. Not only is it costly and constitutionally dubious, but it also risks making prescription drugs even less affordable and accessible— precisely the opposite of what our communities need.
Start with the legal facts. Just across the Mississippi, Arkansas passed a ban on PBM pharmacy ownership, only to end up in federal court. The law was quickly blocked by a judge for likely violating the U.S. Constitution’s Commerce Clause, which protects against state laws that discriminate against or burden out-of-state businesses. The resulting legal battle isn’t cheap— lawsuits like these gobble up taxpayer dollars, drag on for years, and distract our state from actually fixing real health care problems.
Do we really want to spend our tax dollars defending a law that the courts are probably going to strike down? That money could be helping a rural hospital keep its doors open, funding prescription assistance, or improving our state’s health care infrastructure.
Beyond the legal mess, the real danger is what this would do to the people of Louisiana. Over half our state relies on prescription coverage run through PBMs— whether you’re on Medicaid, have employer-sponsored insurance, or are trying to care for an aging parent in a rural parish. PBMs negotiate directly with drug manufacturers, securing the discounts and rebates that keep medicine even remotely affordable. Without them, pharmaceutical corporations would set the price, and everyone else— patients, insurers, even state Medicaid— would just have to pay up.
We know what’s at stake. Louisiana has some of the nation’s highest rates of diabetes, hypertension, and chronic illness. Without PBMs using their scale to lower costs, life-saving drugs like insulin and heart meds would surge in price. For families already on the brink, that means skipping doses, going without, or falling into debt.
Some claim that banning PBMs from owning or affiliating with pharmacies would protect local drugstores, but history and economics say otherwise. Without PBMs, the entire system of negotiated contracts falls apart, reimbursements become unpredictable, and smaller pharmacies lose the financial stability that comes from cooperation. In Arkansas, pharmacy leaders themselves worry the ban would lead to closures, not more competition.
Meanwhile, big corporations and drug makers would have even less incentive to lower prices or negotiate better deals. Costs for insurers and the state would go up, and those costs get passed right back to Louisiana taxpayers, employers, and families. Everyone loses— especially those living on the economic edge.
Nobody’s says PBMs are perfect. They need to be transparent, accountable, and fair to independent pharmacies and patients alike. But tearing down the entire system over the objections of courts and at the urging of big drug companies is reckless.
A ban like the one in Arkansas is not only constitutionally unsound but also deeply out of step with what Louisiana really needs: lower costs, better drug access, and a fair shake for every community, from New Orleans to Natchitoches.
As a health care expert and a Louisianian, I urge my state’s leaders to not repeat our neighbor’s mistakes. Let’s invest in commonsense oversight, ensure that PBMs serve Louisiana patients and pharmacies, and focus on what matters: access, affordability, and health for all our people.
Anything else is a costly, dangerous distraction, and Louisiana deserves better.
Jordan Coopwood works at Ten One Strategies, a public affairs firm.
