Every Sunday I stand in front of a congregation that includes retired soldiers, active National Guard members and military spouses who have moved their families across the country more times than they can count. I’ve led this congregation for roughly two years, but I also spent 27 years in the Army and the Air Force. Like them, I am a TRICARE beneficiary.

So when I hear that many lawmakers are considering Pharmacy Benefit Manager reform, I don’t hear an abstract policy debate. I hear a question about whether the people sitting in my pews will still be able to get their medicine.

What most people don’t understand about TRICARE is that beneficiaries don’t get to shop around the way someone with employer insurance might. Federal contracts determine which pharmacies are in-network. If a local pharmacy closes, cuts hours or gets squeezed out of a network because reimbursement rates no longer cover its costs, a veteran or military family cannot simply drive to the next block. 

Moreover, pharmacies around the country have been closing at a pace that should worry anyone who cares about healthcare access, not just PBM industry stakeholders. I encourage lawmakers to do their own research, but the trend — fewer independent pharmacies, more pharmacy deserts — is real. 

That’s why I urge Arizona lawmakers not to dive into the abyss of restrictive PBM reform, like Tennessee and Arkansas, just because we need to make drug prices lower. If they do, ask the question: does the reimbursement structure in this legislation let community pharmacies stay open? If the answer is no, please consider the reckless damage it could inflict on a community.

I know some of you reading this will think, “But many of these bills in other states offered veteran carve-outs. You won’t be affected.” That’s wishful thinking. A pharmacy doesn’t serve one insurance card at a time. If a reimbursement structure makes it impossible for a community pharmacy to keep its doors open, that pharmacy closes for every patient who walks through it, not just the ones covered by TRICARE. A special exemption for military families, while the underlying economics stay broken, doesn’t protect them. It just delays the day their pharmacy closes.

As a military assistant chaplain, I’ve counseled families through deployments and the disruption of military life. The people who wear uniforms, and the families who hold things together while they do, have earned a healthcare system that works for them, not one that gets rebuilt around them without anyone checking whether it still functions when it’s finished.

So while you’re working to fix the drug pricing system, please don’t leave veterans standing outside a pharmacy that used to be open.

Pastor Barry Upshaw has led Salt of the Earth Baptist Church in South Phoenix for approximately two years. He is a 27-year Army and Air Force veteran and a TRICARE beneficiary.