A way to improve rural health care
We need strong and smart legislative fixes to the 340B program that reduce abuses to return the program to expanding affordable health care for vulnerable or uninsured patients.
For a state like Oklahoma, improving citizens’ access to affordable health care and medicine is a critical priority. With approximately one-third of Sooners residing in rural areas, and a large number living on tribal lands, the state needs strong rural health clinics and Federally Qualified Health Centers (FQHCs) to care for its residents.
More than 25 years ago, the federal 340B Drug Discount Program was created to help health care safety net providers, such as FQHCs, rural health clinics, and some hospitals deliver more affordable prescription drugs and health care services to vulnerable or uninsured patients. Pharmaceutical manufacturers sell drugs at steep discounts to the providers. In turn, these providers are expected to use the savings generated by their participation in the 340B program to provide affordable medication for patients.
But due to 340B’s lack of clear guidance and oversight, many hospital providers have taken advantage of it to reap significant profits and pad their bottom lines without an increase in access to affordable care for vulnerable patients.
The current law allows large disproportionate-share hospitals to qualify for participation in the 340B program, but they are not required to report how many vulnerable or uninsured patients receive discounted drugs, as federal grantee providers like FQHC’s, Tribal/ Urban Indian Health Centers and others must do. Many of these large corporate hospitals have exploited this loophole to sell drugs at the full market price to low-income patients. These hospitals then pocket the difference.
Reports also show that patients at 340B hospitals are prescribed more medicines or more expensive medicines than at non-340B hospitals, all while paying a higher price than what the hospital paid for those medications. These trends have led to a reduction in the availability of affordable, communitybased care and an increase in prices for much-needed treatments.
We need strong and smart legislative fixes to the 340B program that reduce abuses to return the program to expanding affordable health care for vulnerable or uninsured patients.
Thankfully, leaders in Washington are proposing legislative solutions to the problem. Reps. Larry Bucshon, R-Ind., and Scott Peters, D-Calif., introduced H.R. 4710, the 340B PAUSE Act, and Sen. Bill Cassidy, R-La., authored S.2312, the HELP ACT. These bills propose a temporary freeze on the number of large disproportionate-share hospitals participating in the program and require basic reporting information to be shared with the public. Both bills would also ensure that rural hospitals, FQHCs and community clinics already participating in the 340B program remain open to serve the populations that rely upon them.
We encourage the residents and federal representatives of Oklahoma to support these legislative fixes. As our elected leaders look to improve rural health care access, fixing the 340B program would go a long way toward achieving this goal.