When you take a look at the ownership and the number of lives and the billions in revenue at stake it is going to be an uphill battle for this bill to pass. Just like the ACA. The largest health plans brokered that legislation to their benefit. They jumped in and let the smaller start ups enter the ACA market. ~10 years later, most of small players who entered the market are gone. UHC and Humana dominate ACA plans.

IngenioRx - Elevance (formerly Anthem) (41.5M Lives)
CVS - Aetna (24.4M Lives)
Prime Therapeutics - Blues Consortium including HCSC (~25M Lives)
OptumRx - United Healthcare (51M Lives)
Express Scripts - CIGNA (18M Lives)

Humana is in-house
Centene outsources pharmacy to Express Scripts (27M Lives)
Kaiser outsources to OptumRx and MedImpact