Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]

On December 11, 2025, Representative Auchincloss (D-MA) introduced HR6610, the Pharmacists Fight Back in Federal Employee Health Benefit Plans Act, with 32 cosponsors including Rep. Comer (R-KY), chairman of the House Oversight Committee. The bill was referred to the House Committee on Oversight and Government Reform and has no further action history — it remains in early legislative stages. The bill amends 5 U.S.C. §8904 to require all FEHBP health plans to mandate that their PBMs reimburse in-network pharmacies at the National Average Drug Acquisition Cost (NADAC) plus the lesser of 4% or $50, plus the state Medicaid dispensing fee. It also requires PBMs to pass 100% of manufacturer rebates through to patients at the point of sale by reducing coinsurance/copayments. There is no funding authorization — this is a regulatory mandate, not a spending bill. The three largest publicly traded PBMs — OptumRx ($UNH), Express Scripts ($CI), and Humana Pharmacy Solutions ($HUM) — administer prescription drug benefits for FEHBP plans. Under current practice, PBMs negotiate reimbursements below NADAC and retain a portion of manufacturer rebates as profit. HR6610 would eliminate both profit levers on the FEHBP book. However, FEHBP represents a small fraction of total PBM claims volume — the commercial market, Medicare Part D, and state Medicaid programs are far larger. The immediate financial impact on UNH, CI, and HUM is limited to tens-to-hundreds of millions annually — not a material earnings event for companies with $100B+ (UNH), $50B+ (CI), and $40B+ (HUM) in revenues. The real risk is precedent: bipartisan support for PBM reform, including the Oversight Committee chairman, signals that similar mandates could be proposed for Medicare Part D and commercial plans in future sessions. Over the trailing 30 days through April 30, 2026, UNH is up 36.34%, CI up 9.35%, and HUM up 38.19% — primarily driven by broader market and sector trends rather than this early-stage bill. The next legislative step is committee markup in the House Oversight Committee, which has not been scheduled. Without a Senate companion bill or committee action, the probability of passage in the 119th Congress remains low. Investors should monitor whether Chairman Comer advances the bill and whether a Senate version emerges — those events would materially increase the bearish thesis for large-cap PBMs.