Healthcare reform takes many forms, and some are better known than others. One that can sometimes slip under-the-radar is the 340b program, which requires drug companies to provide medications at a reduced rate to certain organizations including rural referral centers, hospitals providing indigent care, and critical access hospitals.

There is no taxpayer expense to ensuring that these people in need are able to afford the medication they need. The program simply ensures that critical medical providers are able to remain open to serve populations that would otherwise struggle to receive medical care while offering vital prescriptions at affordable prices.

President Trump clearly cares about serving this population, signing off on a 340b price transparence tool and an extension of 340b ceiling price rules which would give providers peace of mind. Once in office, however, Trump has found himself surrounded by big pharma lobbyists and lawyers who have no interest in reducing these prices, and are actively working against 340b.

One of these is Joe Grogan, head of White House Policy Council. Previously, he was a lobbyist for Gilead Sciences, one of the twenty largest pharmaceutical companies in the world. In fact, Gilead joined The Pharmaceutical Research and Manufacturers of America (PhRMA) specifically to work on “fixing the 340B Drug Pricing Program,” among other goals according to a PhRMA press release.

Grogan is mischaracterizing the 340b program, painting it as one that hurts taxpayers to support fat cats. “There are too many distortions, too many games being played, and too much money being sucked out of the pockets of American patients and taxpayers without fair value. It has to stop,” he said at the Federation of American Hospitals (FAH) annual conference. FAH hospitals do not participate in 340b.

In the summer of 2018, HHS Secretary Alex Azar met with GOP House lawmakers and suggested standardizing the discount offered by the 340b to 20 percent. This would be a huge hit to rural and critical-access hospitals which currently receive discounts up to 60 percent. Several GOP legislators promised to push back.

“Most critical-access hospitals are barely surviving,” Rep. Chris Collins (R-NY) told Modern Healthcare “Having 340B tied to a 20% discount to the list price would be devastating for them.”

President Trump is trying to support these communities by making healthcare more accessible, but he is surrounded by those who would make that difficult. He needs to remember his campaign promises.