Nov. 10, 2022— It is safe to say the 340B drug pricing program would not be what it is today without former Congressman Henry Waxman. In fact, 340B might not even exist. As chairman of the key congressional committee with jurisdiction over health care programs, the California Democrat was the lead author of the legislation that created 340B in 1992. To mark the 30th anniversary of 340B on Nov. 4, our 340B Insight podcast features an interview with the congressman to hear more about how he helped create 340B and discuss his thoughts on its legacy.
The 340B law requiring pharmaceutical manufacturers to provide discounts on certain outpatient medications to safety-net hospitals, community health centers, and clinics is one of Waxman’s many legislative accomplishments during more than 40 years in Congress, including serving as chairman of the House Energy & Commerce Committee.
340B was the product of bipartisan discussions in the House and Senate and was signed into law by President George H.W. Bush. According to Waxman, Congress’s desire to protect and strengthen the health care safety net was the primary reason he and a bipartisan group of his colleagues created 340B. The core concept of the law was to give safety-net providers access to the lowest price possible for medications. It followed earlier legislation that reduced the amounts that state Medicaid programs would pay for covered drugs.
“There was bipartisan support for protecting the health care safety net and programs like Medicaid and Medicare to cut back on the amount that they would pay for the care that they were giving,” Chairman Waxman said. “This helped [the providers] recover what the safety-net public programs were able to pay at a lower price and give them that ability to get a discount on the drugs and have money left over to provide additional services to low-income people.”
Waxman also was one of the leaders in 2010 of the effort to enact the Affordable Care Act, which allowed critical access hospitals, rural referral centers, sole community hospitals, cancer hospitals, and children’s hospitals to become eligible for 340B. Members of Congress again worked across the aisle to support 340B. Waxman explained that this time it was New Mexico Senator Jeff Bingaman, a Democrat, and South Dakota Senator John Thune, a Republican, who led the effort to expand access to 340B. The senators wanted rural hospitals to have access to 340B resources to help them remain open and available to their communities.
A Continued Focus on the Safety Net
Much has changed in the 30 years since 340B became law. This includes advances in the technology and medications available to care for patients. What has not changed is the need for a strong health care safety net or the need for 340B, Waxman said.
“We should be very proud of the program,” he said. “340B has helped preserve the safety net during a time of economic upheaval and a global pandemic. Things would be so much worse if we didn’t have the 340B program.”
Listen to our full interview with Chairman Waxman on your favorite podcast platform.