Pharmacists Fight Back in Medicare and Medicaid Act

HR6609, titled the 'Pharmacists Fight Back in Medicare and Medicaid Act,' was introduced in the House of Representatives on December 11, 2025. It has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means. The bill aims to amend titles XI, XVIII, and XIX of the Social Security Act to establish new requirements for prescription drug benefits and pharmacy benefit managers (PBMs) under Medicare and Medicaid. Specifically, it mandates that PBMs pass through rebates and prohibits steering practices, with an effective date for plan years beginning on or after January 1, 2027. This bill does not authorize or appropriate a specific funding amount. Instead, it imposes new regulatory requirements on PBM operations within existing Medicare and Medicaid frameworks. The mechanism is regulatory: PBMs would be legally required to alter their business practices regarding rebate handling and pharmacy relationships, directly impacting their revenue models and operational costs. The bill's intent is to increase transparency and reduce drug costs for consumers by limiting PBM margins. Structural losers under this legislation would be companies with significant PBM segments, as their profitability from these operations would be directly curtailed. This includes CVS Health Corporation ($CVS), which owns Caremark; The Cigna Group ($CI), which owns Express Scripts; and UnitedHealth Group Incorporated ($UNH), which owns Optum Rx. Elevance Health, Inc. ($ELV) also has PBM operations through CarelonRx. The bill's provisions for rebate pass-throughs and anti-steering measures are designed to reduce the financial leverage and revenue streams PBMs currently derive from these practices. Conversely, independent pharmacies and potentially consumers could be structural beneficiaries due to increased transparency and potentially lower drug costs. Looking at recent market data, $CVS is currently at $73.28, up +4.48% over the last 7 days but down -6.88% over the last 30 days. $CI is at $275.69, up +6.82% over 7 days but down -1.98% over 30 days. $UNH is at $281.36, up +7.48% over 7 days but down -2.57% over 30 days. $ELV is at $302.61, up +6.26% over 7 days and up +5.63% over 30 days. While all these PBM-affiliated stocks have seen positive movement in the last 7 days, their 30-day performance for $CVS, $CI, and $UNH shows declines, suggesting broader market pressures or sector-specific concerns that predate this specific bill's introduction. The bill is in its early stages, having only been referred to committees, and requires further legislative action to advance. Key legislative steps remaining include committee consideration, potential markups, votes in both the House and Senate, and ultimately, presidential assent. With 34 cosponsors, including members from both parties, the bill shows some bipartisan support, which could aid its progression. However, being referred to two committees indicates a complex path forward.