For millions of Americans, the cost of healthcare often comes with a painful decision: prioritize their health, or safeguard financial security.
Over 30 years ago, Congress established the 340B Drug Pricing Program, a federal program designed to help. But today, the 340B program is drifting from its original mission, leaving many low-income and uninsured patients without the support they deserve. The Congressional Budget Office’s (CBO) September 2025 analysis confirms the program has grown far beyond anything Congress anticipated, rising from $6.6 billion in drug purchases in 2010 to $43.9 billion in 2021, largely due to hospital consolidation and contract pharmacy expansion.
The 340B program was created to help hospitals provide affordable care to patients who need it most. Under the program, hospitals receive discounts on medications, which are supposed to lower costs for patients and support community health services.
Unfortunately, a lack of transparency and accountability has allowed some hospitals to use 340B discounts in ways that don’t directly benefit patients. The program has allowed for some institutions to redirect 340B savings to wealthier areas, leaving many lower-income patients facing charges they can’t afford.
Thomas Johnson, Executive Director of The Alliance to Save America’s 340B Program (ASAP340B), explained: “We cannot continue allowing hospitals to profit from a broken system and vulnerable patients. The program must be reformed to ensure hospitals serve patients as it was originally intended.”
The Senate Health, Education, Labor, and Pensions (HELP) Committee recently held a hearing examining the program. Lawmakers recognized both its potential to help patients and the serious gaps in how it operates. Strong evidence from Senator Cassidy’s report and the Congressional Budget Office’s findings further highlight the need for reform.
One proposed solution in the House of Representatives is the 340B ACCESS Act, which aims to improve transparency, ensure savings reach patients, and restore the program’s original mission. The Senate “Gang of Six,” a bipartisan 340B working group which includes Senators Jerry Moran (R-KS), Tammy Baldwin (D-WI), and Shelley Moore Capito (R-WV), Tim Kaine (D-VA), Markwayne Mullin (R-OK), and John Hickenlooper (D-CO), has committed to working toward a federal solution for 340B reform. This hearing was a helpful step forward.
Johnson emphasized: “Bipartisan concern about the program is a critical step toward putting patients first – ensuring they can access life-saving healthcare without financial strain.”
The stakes are especially high for Black patients, who are more likely to face barriers to affordable care. Findings from the CBO and the HELP Committee highlight a central concern: every day that the program continues to operate without oversight, more patients risk both their health and their financial stability.
It’s time for Congress to act. Strengthening the 340B program isn’t just about policy – it’s about making sure our communities receive the support and care they deserve.
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