By Senator Doug Steinhardt, July 14 2026 12:06 pm Most New Jerseyans have never heard of a pharmacy benefit manager. Pharmacy benefit managers, or PBMs, are the middlemen in the prescription drug system. They decide which drugs are covered, what you pay and even where you fill your prescriptions. That’s a lot of power. And that power is being used in ways that should worry every patient, employer, taxpayer and local pharmacy in New Jersey. Recently, New Jersey State employees were told that beginning July 1, 2026, certain long-term medications classified as “maintenance medications” must be filled through Optum Home Delivery to receive full prescription coverage. Sure, you can still use your local pharmacy, but you must pay the full prescription price yourself. Imagine if your auto insurance company told you it would only pay to repair your car if you used a body shop…

This issue only recently hit public employees, but it didn’t start and won’t end there. New Jersey has more than 9.5 million residents. Every one of you should be concerned if the future of prescription coverage becomes this: You may have a drug plan, but only if you use the PBM’s pharmacy, accept the PBM’s conditions and follow the PBM’s rules. You may never see your local pharmacist again. Other PBMs in New Jersey have moved or are moving in the same direction. It’s a business model spreading across the market and it threatens your freedom, your choice and maybe even your health. If we wait until every prescription plan works this way, it’ll be too late. I want to be clear: mail-order pharmacy isn’t the enemy. Many patients like it. For some, it’s convenient, reliable and cheaper. They should be free to use it. But you should also be free not to use it.