Author: Katherine D. Brodie

On April 14, 2025, a bipartisan group of 39 state attorneys general wrote to House and Senate leadership to express concerns about “the threat posed to the health and healthcare of the American people stemming from the increasingly consolidated healthcare market under the control of Pharmacy Benefit Managers (“PBMs”).” The next day, President Trump signed an Executive Order directing federal agency actions including scrutiny of the role of PBMs.

The state attorneys general urged Congress to legislate federally to prohibit PBMs, their parent companies, or affiliates from owning or operating pharmacies, with the goal of “foster[ing] fair competition and promot[ing] choice and transparency for the American people.”

PBMs, third-party administrators of prescription drug programs for health plans created to process claims for drug companies, were originally intended to assist in lowering costs for consumers. The state attorneys general express concern that PBMs are using manufacturer rebates to increase, rather than decrease, drug prices. They are also concerned that PBMs influence the market as middlemen, raising prices for consumers, including though the use of affiliated pharmacies owned by a PBM or PBM parent company.

Momentum appears to be gaining to address the issue. On April 15, 2025, President Trump published an Executive Order, “Lowering Drug Prices By Once Again Putting Americans First.”

Among other things, that Order directs that, within 90 days of the order, the Assistant to the President for Domestic Policy, in coordination with the HHS Secretary, the OMB Director and the Assistant to the President for Economic Policy, provide recommendations to the President on “ how best to promote a more competitive, efficient, transparent, and resilient pharmaceutical value chain that delivers lower drug prices for Americans.” The Order also directs improvements in PBM transparency by requiring, within 180 days of the date of the order, the Secretary of Labor to propose regulations pursuant to Section 408(b)(2)(B) of the Employee Retirement Income Security Act of 1974 to improve employer health plan fiduciary transparency into the direct and indirect compensation received by PBMs.

Attorneys general for the following states signed the letter: Arkansas, Alaska, American Samoa, Arizona, California, Delaware, the District of Columbia, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming.

On February 25, 2025, a bipartisan group representing a majority of state attorneys general sent a Letter to Congress urging bipartisan congressional action to address organized retail theft.  Citing gains made in the last Congress with the introduction of the Combating Organized Retail Crime Act of 2023 and the Organized Retail Crime Center Authorization Act of 2023, the Letter explains that the legislation is needed to provide necessary state and federal resources to curtail organized retail crime and the violence associated with it in communities across the country. Impacted retailers include Walgreens, Walmart and Target, which have had to close stores and ramp up security to protect employees and stem losses, with total financial losses from organized retail theft amounting to over $121 billion. The Letter notes that approximately 76% of store managers report impacts on their employees.

Federal legislation is needed, according to the authors, because the problem is larger than state resources available.  The states seek greater cooperation with federal law enforcement through a proposed Organized Retail Crime Coordination Center at the Department of Homeland Security to address the complexity and scope of the organized retail crime problem, which also includes supply chain infiltration by organized crime. The states urge Congress to strengthen federal penalties for supply chain thefts and to appropriate additional funding to the states for law enforcement.

The letter is signed by attorneys general from Alabama, Alaska, Arizona, Arkansas, Delaware, Connecticut, Florida, Georgia, Hawaii, Illinois, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, Washington, D.C., and West Virginia. 

On November 12, 2024, under the leadership of the National Association of Attorneys General, 47 state AGs joined in a Comment responsive to the Federal Communications Commission’s recent proposals to increase accountability and accuracy in Robocall Mitigation Database (“RMD”) filings. See Notice of Proposed Rulemaking, Improving the Effectiveness of the Robocall Mitigation Database, WC Docket No. 24-213, et al., Adopted August 7, 2024.

The Comment notes that the RMD is an essential resource in State AGs’ efforts to combat illegal robocalls. Since 2021, providers have been required to register on the FCC’s database to operate as a voice service provider in the United States. The registration process, according to the Comment, has not prevented bad actors from obtaining legitimate registrations to send illegal robocalls.

The Comment notes that information submitted by providers to the RMD can often be false or inaccurate to the detriment of consumers. Such deficiencies can include false, incomplete, or misleading contact information, blank or inapplicable mitigation plans, and representations which are contradicted by other FCC filings or publicly available sources.

The coalition of AGs supports FCC proposals that include additional procedural measures after submission of required information to RMD; potential technical solutions to identify and require correction of data discrepancies in filings; measures to increase accountability for providers that submit inaccurate and false information to the RMD or fail to update their filings when the information they contain changes; and other steps to increase the effectiveness of the RMD as a compliance and consumer protection tool.

State AGs from the following States signed the submission: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, Wisconsin, and Wyoming.

On October 30, 2024, sixteen (16) Attorneys General wrote to House and Senate Republican and Democrat leadership in support of Congress taking action to establish a federal penalty for price gouging during times of economic crisis. Despite varying types of anti-price gouging laws in 40 states, the AGs note that the national scope of product supply chains requires a federal-state partnership to adequately protect consumers and small business from price hikes, hoarding and supply restrictions that can result from profiteering. The letter seeks to distinguish its support for temporary, targeted price gouging prohibitions from price caps or ceilings of the past that were not narrowly targeted and harmed businesses responding to market conditions to maintain profit margins. The type of federal prohibition the group supports would be directed toward excess profit making in times of crisis, as states across the nation experienced during the COVID-19 pandemic and after global oil and gas market disruptions.

The letter notes that states have “successfully held up-chain distributors and manufacturers accountable for the harm they caused both to consumers and small businesses,” but that “without a national prohibition in place, states face resource challenges and additional litigation uncertainty when pursuing upstream, out-of-state producers and sellers” and “those gaps incentivize businesses to push price gouging activity up the supply chain in order to complicate price gouging enforcement by individual states.” A federal price gouging ban would assist in eliminating such incentive, according to the AGs.

In short, the AGs believe that a federal price gouging prohibition that complements current state prohibitions would “allow federal enforcement agencies, such as the Federal Trade Commission, to identify and restrain unjustified and irrational price increases throughout the entire supply chain, unconstrained by the complications of State-by-State enforcement”.

The letter was signed by the attorneys general of New York, California, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Oregon, New Jersey, New Mexico, Pennsylvania and Vermont.

On September 9, 42 state attorneys general joined a National Association of Attorneys General Letter to House and Senate leadership supporting legislation to establish a surgeon general’s warning label on algorithm-driven social medial platforms, stating that social media is associated with significant mental health harms for adolescents. According to the state AGs, such platforms represent a serious public mental health threat, closely linked to youth depression, anxiety and suicidal ideation.

The Letter follows previous efforts taken by state attorneys general— including Arkansas, Indiana, Iowa, Kansas, Nebraska, New Hampshire, and Utah—but  advocates for federal intervention. 

According to the AGs’ letter, a federally mandated surgeon general’s warning “would be a consequential step toward mitigating the risk of harm to youth.” The authors urge Congress to seriously consider this and other steps to protect youth in the face of emerging technologies, citing the Senate’s passage of the Kids Online Safety Act and Children and Teens’ Online Privacy Protection Act as evidencing bipartisan commitment to protecting youth online.

The following state attorneys general signed the Letter: Alabama, Arkansas,  American Samoa, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, U.S. Virgin Islands, Utah, Vermont, Virginia, Washington, Wisconsin and Wyoming.