As a country, we are struggling to address what has become a tragic opioid epidemic gripping the nation. Our community health care providers are on the front lines of this crisis. While hospitals and clinics work tirelessly to both prevent and treat substance use disorder, they are simultaneously fending off constant threats of budget cuts and sabotage by the Trump administration. The possibility of Republicans cutting billions of dollars from the Medicaid program hovers over our safety net providers, threatening their ability to serve patients with behavioral health care needs.
One, perhaps lesser known, example of this health care sabotage has come in the form of attacks on the 340B Drug Discount program. Safety net providers rely on this vital program to serve their communities, including those suffering from substance use disorder.
Congress created the 340B Program in 1992 to increase the capacity of health-care providers to serve more patients and improve care. It requires drug manufacturers to sell discounted medications to safety net providers, including hospitals and clinics that serve low-income and vulnerable populations. Participants in the program include children’s hospitals, HIV/AIDS treatment centers, opioid addiction clinics, hemophilia treatment centers and other hospitals and clinics serving their communities. Because the 340B program is reliant on private drug companies offering discounts, there is no cost to taxpayers.
Recent attacks on 340B are often veiled as efforts to “reform” the program because of its growth. That is misleading. In fact, because beneficiaries of the 340B Program have demonstrated success in expanding care to their communities, Congress purposefully broadened the program’s eligibility in 2010. So-called reforms are really just disguised attempts to scale back the program.
Critics also claim that the 340B Program is not transparent. That’s not based in reality. Hospitals and clinics that participate in 340B already comply with a variety of extensive reporting requirements, and are subject to periodic audits to ensure compliance with the program. Furthermore, it can be difficult to calculate exact savings in the program because of the lack of transparency around drug prices.
The benefits of this program are clear. Clinics in my district of Sacramento have shared story upon story with me about how this program has helped them serve their patients. It’s important to note that the 340B Program was intentionally created to be flexible so that covered entities could use savings to benefit the community in the most impactful ways. Additional onerous reporting requirements would limit their flexibility to do so.
We should not be devaluing a program that, in addition to helping treat patients with substance use disorder, is also serving a wide array of other health care needs in our communities. That’s why I’ve recently introduced H.R. 6071, the Stretching Entity Resources for Vulnerable (SERV) Communities Act. The bill expands the program to further support behavioral health care, making it possible for grantees of the Substance Abuse and Mental Health Services Administration (SAMHSA) to participate. The SERV Communities Act also improves program integrity by requiring more manufacturer transparency and mandates that the Health Resources and Services Administration (HRSA) publish a ceiling price website so that covered entities can in fact calculate and better report their savings. And, H.R. 6071 clarifies the original intent of the 340B Program: to enhance the ability of hospitals and clinics to provide a comprehensive set of services to vulnerable patients in their communities. As we consider ways we can further advance our health-care system and address the opioid epidemic, the mission behind the 340B Program is something we should all be able to rally around.
Matsui serves on the Energy and Commerce Health Subcommittee.