AIPA statement on SB 247

March 10, 2026

The Alabama Independent Pharmacy Alliance (AIPA) has observed the comments regarding SB247, a bill which passed the Senate before its opponents took notice of its implications. Critics of the bill’s opponents have attempted to undermine those opponents’ arguments by questioning why their opposition was not voiced earlier. The watchers in our state who aim to check the power of the large corporations are largely unpaid citizens who must tend to their own businesses, in contrast to the well-paid lobbyists who aim to advance and consolidate the power of those corporations. Thus, the watchers who would limit that power are not necessarily able to react quickly under all circumstances.

An in-depth reading of SB247 raises numerous, valid questions about its effects on health care in Alabama. Blue Cross Blue Shield of Alabama (BCBS AL) has largely enjoyed the status of a controlled monopoly in our state. SB247 would allow BCBS AL to reorganize itself as a subsidiary of a “nonprofit holding company” that would be subject to less oversight than BCBS AL itself, and which would be controlled by members of BCBS AL’s board. The bill authorizes BCBS AL to initially transfer up to 25% of its admitted assets to that holding company, and further authorizes BCBS AL to pay dividends to the holding company, which may then invest in any number of unspecified assets.

This constitutes an enormous transfer of wealth from the citizens of Alabama to what might be viewed as BCBS AL’s own private equity fund. BCBS AL was formed to provide reasonable costs of care for Alabamians and is designated as a nonprofit. BCBS AL’s assets were amassed, at least in large part, from premiums paid by working families and from tax subsidies. The transfer of these assets and future dividends to a holding company, while legal under nonprofit regulations, appears in practice to be very similar to the taking of profits for use in other investments.

SB247 also has potential to ease vertical integration for BCBS AL. Vertical integration, or ownership of healthcare providers by insurance companies and pharmacy benefit managers (PBMs), has created the current health care landscape of rising costs, rising premiums and lower quality of care in our nation. While SB247 does contain a provision limiting the holding company’s ability to own or control health care providers (like hospitals or physician offices), there is no prohibition on the less-regulated holding company purchasing providers and then divesting its ownership to BCBS AL. The implications of this are not fully known, but are potentially of great consequence to health care providers.

AIPA would urge Alabama’s representatives to consider the unknowns and potentially harmful consequences of codifying SB247. Further study of this issue is necessary to understand the full implications before it is made law.

Alabama Independent Pharmacy Alliance (AIPA) is a volunteer organization comprised of local pharmacy owners, pharmacists and staff dedicated to preserving and forwarding the practice of independent pharmacy in the State of Alabama.

www.aiparx.com Media Inquiries: media@aiparx.com