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An Oklahoma-based dark money group purchased nearly half a million dollars in television advertisements calling on lawmakers to oppose a bill to regulate Tennessee pharmacy benefits managers because it’s “anti-Trump.”

The commercials bought in Knoxville, Nashville and Jackson by Shaping Healthy Initiatives for Tomorrow praised three Senate Republicans for opposing HB1959/SB2040, which would ban a pharmacy from also owning a pharmacy benefit manager, PBM.

PBMs are the middlemen that negotiate drug reimbursement rates between pharmacists and insurance companies. The Tennessee Department of Commerce and Insurance found in an audit that the three largest PBMs in Tennessee use their market position to give affiliated pharmacies favorable reimbursement rates.

The Tennessee legislation would target CVS Health, the only company in Tennessee to own both a PBM (CVS Caremark) and brick-and-mortar pharmacies. CVS has been running its own million-dollar campaign opposing the legislation, arguing that passage would force it to close 134 locations and “threaten” pharmacy access for thousands of Tennesseans.

The Tennessee Commerce and Insurance Department found that CVS Caremark was reimbursing its own pharmacies in some cases 16,000% more for a specific drug than non-affiliated stores. CVS Health’s CEO also sent letters to lawmakers arguing it’s not possible for CVS Caremark to stop operating in just one state.

When Arkansas passed a bill similar to Tennessee’s in 2025, CVS and other PBMs filed a lawsuit temporarily halting its enforcement, a case that is ongoing.

CVS says bill will force closure of 134 pharmacies in Tennessee. Lawmaker calls it ‘fear-mongering.’

What’s in the ad?

The Shaping Healthy Initiatives for Tomorrow advertisements start by praising President Donald Trump’s new prescription drug website, TrumpRx. Then it ad goes on to either praise Sens. Jack Johnson of Franklin, Becky Massey of Knoxville or John Stevens of Huntingdon for “fighting “ against high drug prices by opposing the legislation.

Stevens, who was unfamiliar with the group buying the ads, said he opposes the PBM bill because it will ultimately drive up costs.

“When I ran for office in 2024, one of the things my constituents brought up time and time again was the rising cost of healthcare,” Stevens said. “I made a commitment to them that I would fight the increasing costs.”

Officials with TennCare and the state Department of Finance and Administration told lawmakers that the passage of the PBM bill would likely cost the state tens of millions more in increased costs passed on through insurance.

But the bill has backing from the legislature’s top Republicans, House Speaker Cameron Sexton of Crossville and Lt. Gov. Randy McNally of Oak Ridge, and the Tennessee Pharmacy Association. The legislation has become a proxy fight between small, independently owned pharmacies and the larger chain stores.

About 80% of the advertisement purchase was concentrated in Nashville praising Johnson, who as the majority leader is the most prominent state lawmaker opposing the bill.

The bill’s primary sponsor, Republican Sen. Bobby Harshbarger of Kingsport, owns a family pharmacy. McNally and two other Senate co-sponsors are also pharmacists by trade.

Shaping Healthy Initiatives for Tomorrow is registered under a post office box that is linked to other political organizations in Oklahoma, but no identifiable company.

The group has its own version of the organization in Oklahoma.

The PBM regulation bill has cleared all its state Senate committees and has one left in the state House before it can be voted on by both legislative bodies.

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