During a recent Senate HELP Committee (Health, Education, Labor, and Pensions) hearing, senators from both parties—including Committee Chairman Bill Cassidy (R-LA), Tammy Baldwin (D-WI), Tim Kaine (D-VA), and Susan Collins (R-ME)—highlighted how Community Health Centers (CHCs) in their states responsibly use 340B savings to lower drug costs and expand access to care for the up to 52 million patients they serve.
The hearing examined the growth of the 340B program and its impact on patients. The HELP Committee heard from subject matter experts Michelle Rosenberg of the Government Accountability Office (GAO), Dr. Aditi Sen of the Congressional Budget Office (CBO), and UCLA physician Dr. William Feldman. Many Senators shared examples of how health centers use the 340B program to lower patients’ out-of-pocket drug costs and reinvest savings in enabling services. They emphasized the importance of protecting health centers’ access to the program while also calling for reforms and greater transparency.
Before the hearing, NACHC CEO Dr. Kyu Rhee wrote to Chairman Bill Cassidy (R-LA) and Ranking Member Bernie Sanders (I-VT), thanking them for their focus on 340B and highlighting the reforms necessary to protect patients’ access to care.
Chairman Bill Cassidy (R-LA) opened the hearing by summarizing findings from his investigation into how 340B revenue is generated and used. In his remarks, he shared that a smaller health center in Louisiana reported, “The cost of compliance and fees forced upon them by the middlemen made it almost unprofitable to participate in 340B, and they were thinking of dropping their participation.”
His remarks reflect concerns shared by many Senators during the hearing that fees and restrictions from drug manufacturers and Pharmacy Benefit Managers (PBMs) threaten the savings that smaller providers, like health centers, depend on.
Senator Tammy Baldwin (D-WI) highlighted how disruptive a rebate model would be to health center finances. In her questioning, she incorporated information from a Wisconsin health center about the substantial increase in upfront costs that would result if the pilot program were implemented. “Under the proposed pilot program, their upfront drug costs would increase by 2,360 percent, threatening their financial stability and, of course, patient care. I’ve heard similar concerns from hospitals, particularly from rural hospitals, and that they would struggle with millions more in additional upfront costs under a pilot program as proposed.”
Senator Tim Kaine (D-VA) focused his remarks on how health centers reinvest 340B savings. The Senator submitted into the record a letter he received from Piedmont Access to Health Services (PATHS). This Virginia health center uses savings generated from 340B to fund obstetrics and gynecologic care after rural hospitals in the area stopped delivering babies. “PATHS delivers about 500 babies a year and 7,000 OB-GYN visits, picking up from where the rural hospitals have not been able to figure out how to make it work,” Kaine said.
Kaine’s example illustrated how 340B can make the difference between access and a lack of access, enabling health centers to maintain critical services and ensuring that rural residents don’t have to travel for hours for care.
Senator Susan Collins (R-ME) offered a powerful example of how health centers use 340B savings to benefit patients directly. She shared that Hometown Health Center in Newport, Maine, uses 340B savings to ensure that patients facing financial hardship can access medications without a copay.
“Hometown Health has also used 340B savings to provide transportation services to homebound patients, to bring them to their appointments and then to the pharmacy to pick up prescriptions.”
Across party lines, Senators recognized the 340B program as a pillar sustaining health center operations. Their stories from Louisiana, Wisconsin, Virginia, and Maine show that when health centers can fully leverage 340B savings, patients benefit.