The short answer: not for price regulation
ERISA, the federal Employee Retirement Income Security Act of 1974, preempts state laws that “relate to” employer-sponsored benefit plans — a law is void if it has “a connection with or reference to” such a plan. For years the PBM trade group PCMA used that rule to strike down state PBM laws. That strategy hit a wall in Rutledge v. PCMA. On December 10, 2020, the Supreme Court ruled 8–0 (Justice Sotomayor writing; Justice Barrett did not participate) that ERISA does not preempt Arkansas’s Act 900, which requires PBMs to reimburse pharmacies at or above their wholesale acquisition cost, to keep their MAC lists current, and to give pharmacies an appeal.
Why the Court upheld Arkansas’s law
The Court’s reasoning turned on the kind of regulation. A state law has an impermissible “connection with” an ERISA plan only if it “governs a central matter of plan administration or interferes with nationally uniform plan administration.” Act 900 did neither: ERISA, the Court held, “does not pre-empt state rate regulations that merely increase costs or alter incentives for ERISA plans without forcing plans to adopt any particular scheme of substantive coverage.” Act 900 was “merely a form of cost regulation.” That holding is what opened the door to the wave of state reimbursement-floor laws.
What Rutledge did not decide
Rutledge upheld rate and price regulation; it did not bless every state PBM mandate. In PCMA v. Mulready (2023), the Tenth Circuit struck down four provisions of Oklahoma’s pharmacy-choice law — covering network-access standards and an any-willing-pharmacy rule — as preempted by ERISA and, in part, Medicare Part D. The court read Rutledge narrowly: Oklahoma’s network restrictions “do more than increase costs,” reaching a central matter of plan administration. The Supreme Court declined to take the case up in 2025, leaving that ruling in place.
Where the line sits today
The practical boundary from these two cases: state laws regulating the prices and rates PBMs pay pharmacies tend to survive an ERISA challenge under Rutledge, while laws dictating plan structure or pharmacy networks are more vulnerable, and Medicare Part D can separately preempt state rules touching Part D plans. PCMA continues to argue some state mandates cross that line — which is why the scope of state PBM authority remains actively litigated. The state tracker records each state’s law and the primary source behind it.