During the 2000 US election, prescription costs-especially for seniors-was a hot issue that both parties offered to resolve. Intervening events have since distracted the federal government from domestic healthcare issues, leaving states to take the initiative in lowering drug expenditures. Two states' programs led the way, drawing legal challenges from the pharmaceutical industry. Recent opinions by US courts of appeals in those cases reached conflicting results; but viewed together, they provide guidance for the types of state plans that will be sustained. Meanwhile, other programs are making their way through state legislatures around the country.