In politics, there is far too often far too much focus on what’s happening in Washington, D.C. and whatever Beltway politicians and the national media deem to be the “news of the day.” Whatever gets splashy headlines is the main focus and lost in the race to churn out clickbait are the stories of everyday hard working Americans and the challenges we face here in our own state.
The inequities in rural health care ranks high on the list of issues that matter greatly to Missourians. Recently, there has been some focus is DC on rural health care with the rural healthcare transformation act and some vital debate also occurred during the back-and-forth surrounding the One Big Beautiful Bill’s proposed Medicaid cuts that our own Senator Josh Hawley fought so hard against.
Since the passage of that bill, some Missouri Republicans, who went to the mat for those same cuts, have attempted to distract from their devastating consequences by attacking the 340B drug discount program. It’s a clever way of pre-emptively arguing that problems with rural health care are not Medicaid cuts that will deprive rural hospitals of much-needed revenue, but rather a nameless, faceless program with a clunky moniker—one that just so happens to be disliked by the well-moneyed, immensely powerful, and often mistrusted pharmaceutical industry.
Here’s how 340B works—for you, me, and everyone else in rural America.
340B pushes pharmaceutical companies to sell their medications to safety net health care providers – – especially those in rural areas – – at a discount. If they agree to do this, they can then also sell their products in the lucrative Medicare and Medicaid markets. If they don’t participate, they lose access to those markets but can continue to charge consumers whatever prices they think people will pay.
The upshot: 340B doesn’t cost taxpayers a dime – – a rarity where federal programs are concerned. 340B allows providers to stretch their resources and provide more comprehensive services to more patients, such as lowering medication costs for patients, improving access to care, and offering more services. And again: All of this is done without costing taxpayers a single penny.
Big beneficiaries of the program are Critical Access Hospitals (CAHs). Critical Access Hospitals are located in a rural area, have 25 (or fewer) inpatient beds, provide 24-hour emergency care, and keep the average length of acute inpatient stays to 96 hour or less. These hospitals can be the difference between life and death in our local communities, and tragically as many as 40% of rural hospitals in Missouri are at risk for closure. These rates are among the highest in the nation.
Of the 67 rural hospitals in the state of Missouri, 35 of them are CAHs and one of our CAHs, Carrol County Memorial, was named one of the top 20 CAHs in the nation. These hospitals depend on 340B to keep emergency room doctors and nurses on staff; to keep fighting the opioid crisis as it still rips through rural America; to keep OB-GYNs working; to afford new MRI machines; and yes, to ensure free or heavily discounted care and medications to those who need them.
This isn’t a handout or welfare program. In fact, it’s really the opposite. Just ask your family, friends or others in the community if they have used the 340B program and you will find a great deal of normal folks that say yes – -many of whom would not have been able to afford the medication otherwise. It saves hard working people a lot of money.
In the wake of Medicaid cuts, 340B will be an even more important lifeline to them which makes the latest drug manufacturer-funded push to dismantle it even more shocking and objectionable and rural health care will remain on life support to the detriment of the people who need it most.
While serving as a State Representative, I fought hard for rural health care, and I will never stop fighting for Southern Missouri. One way I can fight is by making sure we are informed and able to advocate for our rural communities so they will have the resources they need to care for people, especially during their times of greatest need.
Preserving the 340B drug discount program and pushing against big drug manufactures efforts to tear it down via supposed “reforms” is a fight we should be in together. I hope you join me!!
Former State Representative for Missouri’s District 155. He’s a native of Southern Missouri, a dedicated Constitutional Conservative and public servant, an economic developer, high school track coach, and community leader. During a time when many rural hospitals were closing, Travis Smith advocated in DC and helped obtain funding to help expand his community hospital.
