Louisiana lawmakers considered a bill that would have prohibited companies from owning both pharmacy benefit managers (PBMs) and retail pharmacies in the closing days of the 2025 legislative session. The bill, HB 358, died when the Senate declined to vote on it; however, the talk around Baton Rouge is that the legislature will revisit the PBM issue next session.

HB 358 was modeled after a similar bill that was signed into law by Arkansas Governor Sarah Huckabee Sanders. The Arkansas law, Act 624, sought to ban PBMs from owning or operating pharmacies in the state. The law’s constitutionality was challenged before it was scheduled to take effect on January 1, 2026. On July 28, 2025, Judge Brian Miller of the U.S. District Court for the Eastern District of Arkansas granted a preliminary injunction preventing  the law from taking effect because it likely violates the Commerce Clause of the U.S. Constitution, and is likely preempted by TRICARE.

Courts may grant a preliminary injunction when the party seeking the injunction demonstrates that there is a likelihood of success on the merits; that it will suffer irreparable harm if the injunction is denied; that harm to the movant, if denied, outweighs harm to the non-movant if the injunction is granted; and an injunction is in the public’s interest. In situations where a preliminary injunction is sought against a duly enacted state statute that has been publicly debated by the legislature, the court assigns extra weight to the government’s position. Judge Miller granted the movants’ preliminary injunction even with greater deference paid to the State of Arkansas.

Specifically, Judge Miller determined that the parties challenging Act 624 were likely to succeed on their claim that the law violates the Commerce Clause of the U.S. Constitution because it unfairly discriminates against interstate commerce, and there are less restrictive laws already in place to protect consumers and in-state pharmacies. The Court pointed to the statute’s legislative history and the language of the statute itself to demonstrate that lawmakers nakedly intended to protect locally operated pharmacies and discriminate against out-of-state companies.

Furthermore, Judge Miller found that Act 624 is likely preempted by TRICARE, a federal program that provides health insurance coverage to members of the military. TRICARE has existing contracts with some of the plaintiffs in this case and Act 624 would prohibit those PBM-owned pharmacies from delivering healthcare to Arkansas patients. Additionally, Congress intended for TRICARE to operate nationwide; Act 624 would frustrate this system and effectively allow Arkansas state officials to override federal military decisions about healthcare contracts.

Capitol watchers in Little Rock–and Baton Rouge–should stay tuned.