As Alabama lawmakers are debating major legislation to reform pharmacy benefit managers within the state — President Trump recently confirmed that federal-level reform is imminent. 

During an interview with the president last week, Matthew Foldi reported, “President Trump sounded optimistic on the prospects of getting it done before the end of the year, saying “I know [the Senate] is looking at it very very strongly.”

Trump has repeatedly vowed to “knock out the middleman” in drug pricing.

Both the U.S. House and Senate are now moving forward with bipartisan legislation aimed at delinking PBMs’ compensation from drug prices, banning spread pricing for Medicaid, and a range of other measures to accomplish Trump’s mandate. 

Last week, House GOP leaders announced they will re-include PBM reform in their reconciliation bill after efforts broke down in the 118th Congress last year, while the Senate formally revived their efforts last week as well in the form of a bipartisan bill that would overhaul the business practices of PBMs. 

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Impending federal reform might complicate efforts on the state legislative level to address PBMs as strongly as two proposals before the Alabama Senate currently intend.

Two competing bills — SB93 and SB99 — are expected to come up for debate and a vote in the Alabama Senate Banking and Insurance Committee after an initial public hearing in February drew testimony in support and opposition to the proposals.

SB93, sponsored by State Sen. Andrew Jones (R-Centre), seeks to prohibit PBMs from reimbursing pharmacies below their actual acquisition costs and to ban hidden fees related to claims processing and network participation. It would also allow pharmacists to refuse dispensing medication if reimbursement rates are too low.

SB99, sponsored by State Sen. Larry Stutts (R-Tuscumbia) takes a far more aggressive approach with a mandated dispensing fee on every prescription filled and a requirement for PBMs to reimburse pharmacies based on the national average drug acquisition cost.

Lawmakers will return to session on Tuesday for day fourteen of the 2025 legislative session.