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If you talk to pharmacy owners and Medicaid experts, they’ll argue the numbers speak for themselves. When other states put this plan in action, each saved more than $100 million in Medicaid costs and helped local pharmacies at the same time. The question now is if pharmacies in this region, and Virginia as a whole, will see the same benefit. That’s partly up to Gov. Glenn Youngkin, as he decides what to do with the bill that was resubmitted to him out of the General Assembly’s veto session this month. 

The bill in question is SB875, also known as the Save Local Pharmacies Act. It has a twin bill in the House of Delegates, HB2610. The goal of this bill is to streamline government, creating one single, state-contracted Pharmacy Benefits Manager (PBM) for Medicaid. And as mentioned above, making the change in other states has seen some impressive results. West Virginia reported saving $122 million in the first year after making the switch. Ohio officials, meanwhile, claimed the state saved $245 million in one year; Kentucky said it saved $283 million over two years and Texas said it saved $438 million in two years after making the switch. 

It was even one of those rare bills that raced through the General Assembly, passing 40-0 in the Senate, with the House version also getting overwhelming approval 92-2. But the first time it was submitted to Youngkin, he suggested a substitute. He approved of the bill’s general purpose, but wanted to see what the impact would be. 

Before signing off on the change, Youngkin recommended hiring an independent consultant, to do “a comprehensive evaluation of the potential benefits, cost savings and implementation considerations associated with utilizing a single third-party administrator,” his substitute bill reads. “This evaluation shall include an analysis of financial efficiencies, improved transparency and the impact on patient access to pharmacy services, including community critical access pharmacies, along with timelines and cost for both implementation and ongoing operation and maintenance.” 

Calling for change now 

What will the impact be? Will the changes help improve patient access? That’s what Youngkin wanted studied by this consultant, who could not, in the governor’s recommendation, be currently employed by any managed care organization or Medicaid group. His recommendation was rejected in the Assembly’s April veto session, with the original bill sent back for his consideration. Now Youngkin has until 11:59 p.m. on Friday, May 2 to decide if he’ll sign the original, push again for an amendment or veto it outright.  

Multiple pharmacy and drug associations in Virginia are calling for approval of the original. The Virginia Pharmacy Association (VPhA), Virginia Association of Chain Drug Stores (VACDS), Pharmacists United for Truth and Transparency (PUTT), the Virginia Community Pharmacy Association (VCPA), and CPESN Virginia all have released statements arguing a study into this isn’t needed. They point to the existing data from other states that have implemented the change as evidence that it works. 

“Governor Youngkin’s amendment delays critical reforms, preserving a broken system that continues to threaten access to pharmacy care, and will continue spiraling pharmacy costs to patients and taxpayers,” the three groups said in a joint statement. 

Impact on pharmacies

Pharmacies across the Commonwealth are closing at an accelerating pace. The unprecedented 2025 study published in the Journal of the American Pharmacists Association by Virginia Commonwealth University and the Virginia Board of Pharmacy identified 51 pharmacy deserts — communities where residents face extreme barriers to accessing essential medications and pharmacy services. Already, five Virginia counties have no pharmacies at all, and fifteen counties have only one pharmacy, leaving entire populations vulnerable.

“We do not need more studies — we need action,” said Jamie Fisher, the executive director of the Virginia Pharmacy Association. “The Governor’s amendment ignores the very data our state has already collected and the successes we’ve seen in other states. Every day we delay reform, pharmacies are forced to close, and patients lose access to care. Transparency through a single PBM isn’t just good policy; it’s urgent Medicaid reform.”

Fisher’s comments were echoed by Steven Hylton with the Virginia Community Pharmacy Association. 

“We have ample evidence, including data from Virginia’s own DMAS study, as well as proven success stories from Ohio, Kentucky, West Virginia, and Texas, demonstrating the effectiveness of Medicaid pharmacy reform,” Hylton said. “Implementing a single, transparent PBM is a viable solution that can ensure patients maintain access to their local pharmacies. Delaying action will only accelerate closures and further harm Virginia’s communities”. 

What happens next?

The governor has until the end of the night on May 2 to make a decision.