The federal government plans to reduce a 25-year-old benefit to health care facilities that serve low-income people. Who benefits?
Thirty-one organizations in West Virginia would be affected, badly, Michael D. Shaw wrote in the Oct. 22 Sunday Gazette-Mail.
The program, known as 340B, requires pharmaceutical companies to sell drugs to qualifying hospitals and clinics up to 50 percent off, enabling those places to pass the medicines on to their low-income patients, and spend the savings on other needs. To qualify, health centers must show they treat enough low-income patients.
In July, the Centers for Medicare and Medicaid announced it might change how discounts were calculated, and the finalized rule would cost those hospitals and health centers about $1.6 billion starting Jan. 1.
Participating pharmaceutical companies get guaranteed access to Medicaid patients in return for the discounts, Jim Martin, founder of the 60 Plus Association, wrote in The Hill.
The savings are then spent on things those communities need — such as transportation, urgent care and treating homeless people.
The policy change would cut into what those hospitals have left over.
Critics of the program say it has grown too big, that non-poor people are getting too cheap drugs and that it forces drug companies to shift the cost of the discount onto everyone else.
(When has a pharmaceutical company ever needed a reason to jack up the price of medicine? If that were not the industry’s default setting, there would be no need for the 340B program in the first place.)
As far as we can tell, for-profit hospitals and everyone not serving a disproportionate share of poor people might benefit under the federal government’s plan to raise reimbursement rates with the money it would no longer pay to the 340B recipients.
Some hospitals and health centers might also end up with more under the new scheme, but most are expected to lose funding, possibly to the point of having to cut services.
In September, Rep. David McKinley, R-W.Va., joined more than 200 House members to send a bipartisan letter letting Centers for Medicare and Medicaid Services Administrator Seema Verma know how important the program is.
“Protecting access to prescription drugs for low income people should be a priority,” McKinley said in a statement at the time. “Unfortunately, CMS’s misguided proposal would jeopardize the ability of hospitals to provide vital services to vulnerable populations. Our letter shows strong bipartisan opposition to this proposed rule, and hopefully will convince CMS to change course. We must address the high costs of drugs, but this is not the way to do it.”
Well said.
Even if some people are getting a price break on their medicine that they don’t deserve, or someone in the administration doesn’t like how a rural hospital somewhere is spending their money, aren’t there remedies that don’t involve jeopardizing health care providers in communities struggling the most with access to care, aging populations and drug addiction?
