Last week, Republicans took a huge step in restoring fiscal responsibility and putting the American people first. In the Oval Office, President Trump signed into law Republicans’ appropriations package, ending Democrats’ partial government shutdown and moving the Departments of War, Treasury, State, Health and Human Services, and others from a bloated Biden budget to a Trump budget. We also overcame Democrats’ push to defund the Department of Homeland Security by voting to maintain current funding levels through a continuing resolution.

The last time Democrats shut down the government in October, they were fighting to give illegal aliens taxpayer-funded health care. This time, they fought to protect criminal illegal aliens from deportation. Republicans rejected their radical wishlist yet again.

As part of the appropriations package, we secured major victories for Tennessee. Service members at our incredible military installations will see substantial pay increases. Researchers at Vanderbilt University, Oak Ridge National Laboratory, the University of Tennessee, and the University of Memphis will gain additional resources to conduct groundbreaking applied research that strengthens our national defense. Hospitals that serve Medicaid and uninsured patients will receive crucial federal assistance.

In addition, the law saves taxpayers millions by freezing funds to the World Anti-Doping Agency after the organization refused to investigate Chinese swimmers who tested positive for performance-enhancing drugs before the Tokyo Olympics.

President Trump also signed into law legislation that I authored—as well as short-term extensions of provisions I’ve supported—that will strengthen health care across Tennessee. These measures extend telehealth access, expand hospitals’ at-home-care programs, and ensure low-income seniors, people with disabilities, and caregivers can access personalized guidance to navigate Medicare.

I am especially grateful that the President enacted my Ensuring Access to Medicaid Buy-in Programs Act, which ensures working Americans with disabilities are not forced to retire to keep their Medicaid coverage and benefits, and my Patients Before Middlemen (PBM) Act, which lowers prescription drug costs by delinking the compensation of pharmacy benefit managers from drug prices and utilization.

This final piece of legislation is especially important as we work to lower health care costs for hardworking Tennesseans.

In the prescription drug industry, PBMs act as the middlemen between the pharmaceutical companies, health insurers, pharmacies, and patients. In practice, they determine which medications will be covered by health insurance plans and how much patients pay for their prescriptions.

Because their revenue is often tied to the price of a drug, PBMs add administrative fees and rebate-based compensation to list prices and push insurers toward more expensive pharmaceuticals—driving up costs for patients while limiting options. Seniors enrolled in Medicare faced the worst of it, as Part D plan sponsors were allowed to discriminate among pharmacies and favor PBM’s preferred networks. This practice often disadvantaged independent pharmacies that provide essential care for our rural communities.

All the time, I hear from Tennesseans who are fed up with PBMs forcing them to choose between life-saving medication and basic needs. Just recently, I heard from a Tennessean on a telephone townhall who was frustrated with these middlemen for driving up drug prices and hurting seniors like him. Another gentleman who owns several pharmacies throughout rural Tennessee told me price gouging by PBMs forced him to consider whether he could keep his doors open.

In Tennessee alone, a single PBM forced independent pharmacies to pay higher rates for more than 550 medications—costs often passed on to patients—while pocketing $30 million in revenue from spread pricing.

This extortion of the American people is coming to an end. While de-linking PBM service fees from drug prices, the PBM Actalso requires Medicare Part D plans to contract with any willing pharmacy, expanding options for seniors, especially those in rural communities.

No matter Democrats’ attempts to derail President Trump’s agenda, Republicans will continue to deliver for the American people. From bolstering national defense to lowering prescription drug costs, we are proving that conservative leadership gets results.