PBM bills in three states, and what happened to them

Key details

Missouri's SB 984, combined with SB 968, would have limited how often PBMs can audit independent pharmacies and barred charging patients more than the cash price. It was still on the Senate's informal calendar when the 2026 session ended on May 15, so it did not become law.
New Jersey has two new bills, A 5020 and S 4208, that would ban PBM spread pricing and require PBMs to disclose how they price drugs. Both were introduced in May 2026 and sit in committee.
Florida's SB 228, which would have counted copay assistance toward a patient's out-of-pocket maximum, died in committee in 2024, the same idea died again in 2025 in SB 1342, and similar copay accumulator bills are already queued in at least four other states.
Florida's SB 1608 (2024) on 340B drug pricing and SB 1342 (2025), which required notice before formulary changes and would have counted copay assistance toward what patients owe, both died in committee without a hearing.
Contacting your state legislator or a bill's committee chair can influence whether a bill gets a hearing or advances toward a vote.

Pharmacy benefit managers are the middlemen who decide what your insurance actually pays for a GLP-1 prescription, and several states have tried to write new rules for them. Missouri, New Jersey, and Florida have each had bills that touch different parts of that system, from pharmacy audits to drug pricing to copay assistance. None of these bills has drawn much national attention, and none of them names GLP-1 drugs. But because PBMs sit between you and the pharmacy counter, bills like these can change what you pay or where you can fill a prescription.

Missouri's SB 984, combined with SB 968, would have rewritten the rules PBMs use to audit independent pharmacies and capped how often those audits can happen. It also would have barred contracts that let a PBM charge a patient more at the pharmacy counter than that patient would pay in cash. And it would have set up a program aimed at keeping critical access pharmacies open, which matters because those are often the pharmacies serving rural patients. The bill was still on the Senate's informal calendar when Missouri's 2026 session ended on May 15, so it did not become law. A similar bill would have to be filed again in a future session.

New Jersey has two new bills, A 5020 and S 4208, that would ban PBM spread pricing and require PBMs to disclose how they price drugs. Spread pricing is when a PBM keeps the difference between what a health plan pays it for a drug and what it pays the pharmacy. A 5020 was introduced on May 7, 2026, and S 4208 on May 11, 2026, and both sit in committee. Neither bill is about compounded drugs, and neither names GLP-1s. If you fill a prescription through a New Jersey health plan, these bills are aimed at the pricing that sits behind what you pay.

Florida's SB 228 would have required insurers and PBMs to count a patient's copay assistance, including manufacturer coupons, toward that patient's actual out-of-pocket maximum. It died in committee in 2024 without reaching a floor vote. That defeat matters beyond Florida, because it showed opponents of copay accumulator bans where and how to stop similar bills before they advance. The idea behind SB 228 did not disappear. It came back in 2025 as part of SB 1342, which also died in committee. Patients who rely on manufacturer copay assistance for a GLP-1 prescription are the ones this bill was written to protect, and its failure kept that protection out of reach for another cycle.

The same copay accumulator idea that failed in Florida is not confined to Florida. Similar bills are already queued in at least four other states, each proposing to require insurers to count copay assistance toward a patient's deductible or out-of-pocket maximum. That repetition suggests this is less a single-state fight and more a pattern playing out across several legislatures at once. Patients in those states will want to check whether their state is one of the four, since the outcome there will shape whether copay assistance actually lowers what they pay at the pharmacy counter.

Florida's SB 1608, a 2024 bill, addressed protections tied to the 340B drug pricing program. SB 1342, a 2025 bill, would have required insurers to give notice before changing a drug's formulary status, and it would also have counted copay assistance toward what patients owe. Both died in committee without a hearing. Each one addressed a real access problem, from formulary changes that catch patients off guard to pricing protections that hospitals and clinics depend on, but neither made it far enough in the process to reach a vote. Those specific gaps in Florida's drug pricing rules remain open for now.

If any of these bills is moving in your state, you are not just a bystander in this process. State legislators take calls from constituents, and sponsor names are listed on every bill page for exactly that reason. Committee chairs decide which bills get a hearing and which never move at all, so if you want to see a bill advance, that is who to contact. Watching bill numbers is useful, but reaching out is what actually changes whether these votes happen.

By Amanda Bonello

Originally published by Patient Lens on GLP-1 Laws, operated by GLP-1 Studio LLC — a for-profit company founded by the Collective's Executive Director. Republished here in full, with permission, at no cost. The Collective pays nothing for it and receives no payment for publishing it. How this works.