Rural hospitals are already struggling to keep their doors open

Rural hospitals are already struggling to keep their doors open
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The area I represented in Congress is the most rural in America. It spans hundreds of square miles in south and west Texas. Some towns were almost four hours from the nearest airport. In others, it might take law enforcement two hours to respond to a call. To most of my people, rural hospitals were their only hope for health care needs.

As our elected leaders in Washington grapple with how to make healthcare more accessible and affordable for all Americans, rural America should not be forgotten. After the failure of the Congress to repeal and replace ObamaCare, it’s my hope both parties start to work across the aisle, rather than continue to play politics on an issue that  literally has life and death implications for millions of Americans.

One major aspect of healthcare policy that has the potential to dramatically impact lives all across the nation, especially in rural and low-income parts of the nation, is known as the 340B Discount Drug program. It was created to help ensure that low-income individuals get access to their critical medications.


The proposed changes by the Centers for Medicare and Medicaid Services (CMS) would cut the payment rate for many medications purchased through the 340B program. Hospitals that treat high numbers or poor and uninsured, rely on the 340B program to provide lifesaving drugs to the poorest and most vulnerable patients who would not otherwise be able to obtain them. These changes targeting the 340B program will only create further barriers for patients’ access to care, without addressing the real problem of exorbitant drug prices.

Nationwide, rural hospitals are already struggling to keep their doors open. Dozens have closed in recent years, and more than 40 percent currently operate in the red. The CMS payment changes would have devastating consequences to these essential hospitals.

In my home state of Texas, cutting the 340B program is especially problematic. This is due to the fact that the 340B program is a critical financial lifeline for rural hospitals. In fact, since 2003, fifteen rural hospitals have closed across the Texas. In fact, there are 27 counties in the Lone Star State that do not even have a licensed physician.

According to the Texas Department of State Health Services, another 22 states have only a single doctor. In other words, access to healthcare is a serious problem in rural Texas and something our leaders need to try and make better, not worse.

Yet, if CMS reduces the payment rate for the 340B program, there is no question rural hospitals in Texas will become even more desperate, or close altogether. This would be a disaster for residents that rely on rural hospitals, now forced to travel even further to get to an emergency room, or receive critical treatments including dialysis and chemotherapy.

Critics of the 340B program, led by the large pharmaceutical companies who do not like providing discounted prices, often assert that the 340B program is a drain on taxpayers. This simply is not accurate, as payments are handled directly between pharmaceutical companies and hospitals and providers. In fact, the 340B program may save taxpayers money.

Giving patients access to drugs that they wouldn’t otherwise be able to afford, could keep them out of emergency rooms and intensive care units — which can cost taxpayers thousands of dollars a day. We must also consider the human suffering associated with emergency care simply because a patient could not afford preventive prescription drugs.

Opponents of the 340B program also assert that it raises drug prices nationally, since pharmaceutical makers recoup their 340B program losses by raising the prices others pay for their drugs.

However, a study performed by a coalition of 340B program supporters — which includes 1,300 hospitals nationwide — found that the 340B program market only accounts for one percent of drug sales in the United States. According to the report, that 1 percent translated into $6.1 billion dollars in 2015. That same year, the nation’s drug makers spent $27.3 billion dollars on advertising. With these facts in mind, it is hard to comprehend how the 340B program is so impactful on national drug prices.

An overwhelming number of Americans hope the Congress and the President can work together to fix ObamaCare and improve the nation’s healthcare system. The 340B program is a major part of this. As negotiations continue in Washington, many rural Americans are sweating it out, hoping the program survives to serve their healthcare needs.

Henry Bonilla (R-Texas) is a former congressman he served from 1993 - 2007.