Throughout 2026, the SOAA team has been advocating for veterans’ access to unimpeded health care in opposition to harmful legislation that would reform the current Pharmacy Benefit Manager system, through which many veterans receive their medications. Though we have had success in some states, we have particular concern about Tennessee’s recently-enacted Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act (HB 1959 and SB 2040) and its possible impacts on wide swathes of the Tennessee veteran community that rely on PBM Optum Rx for their prescriptions.
After voicing our concerns with the members and committees of the Tennessee House and Senate, with the Tennessee Department of Veterans Affairs, and with the office of the Tennessee Governor, we have written an open letter explaining how legislation like the FAIR Rx Act could create harm, and even prove deadly, for veterans who require unimpeded access to medical care. It would be a poor compensation of veterans’ selfless service to allow them to suffer from the foreseeable outcomes of misguided legislation.
Regarding Tennessee’s Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act (HB 1959 and SB 2040) recently signed into law:
The Special Operations Association of America (SOAA) testified multiple times in Senate and House Committee markups and met with numerous Tennessee House and Senate members to express our deep concern that such legislation will challenge the authority of providers and pharmacies in the state of Tennessee to continue to administer care and prescriptions to veterans, service members and their families through the TRICARE and Veterans Health Administration’s Office of Community Care (VHA OCC) Community Care Network (CCN). SOAA expressed concern that such legislation would impact access to further federally mandated programs of care for veterans, service members, family members, survivors, and caregivers.
Our concern is largely driven by the fact that veterans bear more chronic pain, chronic disease, and mental health burdens than average citizens. Veterans naturally require more prescription drugs to manage these ongoing issues. Losing access to these medicines when pharmacies close through misguided legislation like the FAIR Rx Act would cause undue harm, stress, and potentially even death for those who already put their lives on the line for their country.
Upon learning of the proposed legislation, the Special Operations Association of America met with and sought guidance from the Departments of Veterans Affairs and Defense to understand the whole scope of statute, regulation, and logistical contract law that prescribes care for our members. During this time, SOAA urged the Tennessee General Assembly to ensure these programs were safeguarded before moving the legislation forward. The Tennessee Senate and House attempted a legislative amendment that did not adequately address many federal programs that veterans, service members, and their family members depend on for their federally provided healthcare.
In sum, SOAA directly expressed deep concern for the following federal programs to Tennessee Senate members and committees; House members and committees; the Tennessee Department of Veterans Affairs; and the Tennessee Governor’s office:
CHAMPVA
-The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a comprehensive health care benefits program for spouses, dependents, and survivors of veterans who are permanently and totally disabled, died from a service-connected disability, or died while rated permanently disabled.
-The CHAMPVA program is administered through the Veterans Health Administration’s Office of Community Care (VHA OCC), which currently contracts nationwide with a PBM, OptumRx, that contracts with corporate and independent pharmacies nationwide to fill over 4 million prescriptions annually.
Community Care Network Providers
-The Community Care Network, mandated through the MISSION Act, ensures that veterans and family members have timely and reasonable access to care through Community Care Network Providers (CCN Provider) if VA medical centers are unable to provide such care under statutory guidelines.
-Further, veterans may seek referrals from VA primary care to a CCN Provider for specialty care, or other healthcare needs.
-CCN Providers operate under OptumRx for all prescription services and claims.
Women Veterans OBGYN care
-The Department of Veterans Affairs Medical Centers do not include OBGYN care under their umbrella of care.
-All OBGYN care is referred to CCN providers, and all medications and services prescribed to pregnant Veterans fall under the OptumRx contract.
Urgent and Emergency Care services
-For urgent or emergency healthcare events that necessitate a veteran or covered family member seek immediate medical care, all care and prescriptions from any healthcare facility are administered by the current PBM Contract holder, OptumRx.
The State of Tennessee passed the legislation despite overwhelming concern expressed by the Veteran Service Organization community and veterans. The Special Operations Association of America believes services of federally mandated access to care will be significantly disrupted either due to unintended consequences of this legislation, or due to logistical disruptions of pharmacy access and supply chains throughout the region.
A federal legal challenge to this legislation is expected, as it likely violates the Supremacy Clause, i.e., that entitlements, benefits, and healthcare pathways guaranteed by federal law are not dismantled by state law. Such legal challenges have already occurred in the state of Arkansas, which passed similar language as that passed in Tennessee, and the District Court has placed an injunction on the legislation for similar reasons to those expressed by SOAA to Tennessee legislators.
In the coming months, as courts debate the legality of the new Tennessee legislation, one thing concerns SOAA: Our veterans in desperate need of uninterrupted healthcare will likely have impacted health coverage. Those who have given so much for America should not have to suffer a lapse of healthcare. We owe them that.
