States already have pharmacy deserts. PBM reforms make it worse

Published June 3, 2026 10:00am ET



The states have serious pharmacy access problems, and it’s about to get worse. State lawmakers seeking to address real healthcare concerns are pursuing policies that risk making it even harder for everyday Americans to access care at their local pharmacy.

Nearly 57 million Americans live in a pharmacy desert, generally defined as a high-poverty area with no pharmacies within 1 mile in urban areas or 10 miles in rural areas. In Texas alone, 4.3 million people live in a pharmacy desert. Another 1.8 million Texans rely on a single “keystone” location, where the loss of that pharmacy could also turn their community into a pharmacy desert.

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