The United States Supreme Court heard arguments from Arkansas and others today in support of the Arkansas law aimed at regulating pharmacy benefit managers.

The 2015 law responded to pharmacists’ complaints that the middlemen on drug coverage plans weren’t paying them enough to cover the costs of prescriptions. The managers contend they are exempt from state regulation by federal law.


You can hear the whole (pretty technical) argument here on C-SPAN.

Attorney General Leslie Rutledge is the named lead party in the case against the Pharmaceutical Care Management Association. She did not make the oral argument. Her solicitor general, Nicholas Bronni, did. The U.S. solicitor general and 44 states have joined the Arkansas argument.


In a news release later, Rutledge described the case as a fight to protect family pharmacies and affordable health care. The managers contend THEY hold down drug costs and the Arkansas law, if upheld, will lead to a fractured system rather than a unified standard for pharmacy benefit plans. Those are political points, not legal ones, however. The question is whether the Employment Retirement Security Act of 1974 controls regulation.

Rutledge lost the case before both the federal district court and the 8th U.S. Circuit Court of Appeals.


Today’s argument with a question from Chief Justice John Roberts whose question indicated that the way the Arkansas law was written it seemed to regulate plans, which federal law controls, even if reimbursement rates were an objective.