As Kentuckians struggle with healthcare access, it’s important to keep programs that work | Opinion

Maintaining access to affordable and quality healthcare is becoming more difficult every day for Kentuckians.

In 2020, more than half of residents in the Bluegrass State experienced healthcare affordability burdens and over three-quarters were worried about affording healthcare in the future. A variety of factors have led to this affordability crisis.

The rate of uninsured Kentuckians has climbed over the last several years to 6.4% in 2019, a concerning number that has left hundreds of thousands of residents with few options to access the care that they need. Residents are also finding it increasingly difficult to cover the costs of their prescriptions.

According to the Journal of the American Medical Association, drug prices rose on average, by 11 percent every single year from 2008 through 2021 with the largest jumps in 2020 and 2021. This has caused almost one-third of residents to skip filling a prescription because of cost related concerns.

Given these barriers to accessing care, it is important we preserve and strengthen programs that can help Kentuckians overcome these challenges.

The 340B Drug Pricing Program, for example, has helped hospitals provide charity care for underinsured and uninsured patients as well as safeguarded access to lifesaving drugs for many of Kentucky’s most vulnerable citizens. The program allows certain nonprofit hospitals and healthcare facilities that serve a high number of uninsured or vulnerable patients to buy prescription drugs from manufacturers at discounted prices. Hospitals then use the savings to provide charity care as well as pharmaceuticals to their financially vulnerable patients for free or at significantly reduced costs.

The original purpose of the 340B Program has been successful and has made healthcare available to millions of Americans at little to no cost to American taxpayers and relatively little cost to drug manufacturers. In fact, 340B program covered purchases were a mere 3.6% of the total drug market in 2019. During recent financially challenging times, the 340B program is also more important than ever to keep safety net hospitals open and to help patients access life-saving medications at a price they can afford.

Unfortunately, efforts may be under way to significantly change or end 340B.

In January 2023, Congress introduced a 340B-related bill, H.R.198 - The Drug Pricing Transparency and Accountability Act. The bill, while well-intentioned, requires facilities enrolled in the 340B program to undergo overwhelming administrative burdens to remain in the program. Such bureaucratic requirements will be too onerous for small, financially vulnerable nonprofit facilities.

Some drug companies are also waging a campaign to significantly change or end the program. They have restricted access to 340B-discounted products by making it difficult for consumers to access needed drugs. In addition, these drug manufacturers are attempting to increase the financial and administrative burden on facilities by converting the program into a rebate program. Fortunately, a newly proposed rule promulgated by HRSA to hold drug manufacturers accountable to properly implement the 340B program by establishing a 340B Administrative Dispute Resolution Process may help curtail these disruptive actions.

Now more than ever, the 340B Program is an essential source of stability for the facilities that provide needed health care to at risk Americans. It would be devastating for the federal government or drugmakers to suddenly make significant changes in the 340B Program that would force many nonprofit facilities to curtail the charity care they provide and leave their patients unable to afford their lifesaving medications.

As Kentuckians continue to struggle with the cost of medical care, it is important we preserve programs that help to counter this concerning trend, such as 340B. When the program was created, Congress specifically noted that the intent was to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” 340B funding has allowed just this, stretching precious dollars to be able to provide the level of care needed for at risk populations.

Vickie Yates Brown Glisson
Vickie Yates Brown Glisson

Vickie Yates Brown Glisson is the former Kentucky Secretary of the Cabinet for Health and Family Services and a nationally recognized health lawyer.