Recent Republican primaries have given us a lot to celebrate, as so many establishment candidates have lost to America First ones. One that’s caught a lot of attention is the loss of Senator Bill Cassidy of Louisiana, who was such a RINO he could have applied for endangered species status.
This is the first time in nearly 15 years that a sitting U.S. senator lost a primary in a non-special election. But there’s an extra reason to cheer that Cassidy got scalped over the weekend. Cassidy was a long-time hater of 340B, a healthcare program that benefits mostly rural, Republican voters, including many of the Louisianans Cassidy is supposed to be representing.
We have talked about it here before. The 340B drug discount program has reduced outpatient costs, kept healthcare providers in rural America open, and cut costs for what many Americans pay for lifesaving medications. Started in 1992, 340B requires that drug manufacturers discount prices for medication sold to what are called covered entities: hospitals and clinics that treat a certain threshold of Medicaid patients.
340B was created with the idea that the government should use its leverage to get better deals rather than the other way around (which happens so much). So if drug companies want to bill Medicaid and Medicare for drugs they sell to entitlements—which are 100 percent paid for by taxpayers— they have to offer discounts as a swap.
Big Pharma hates 340B because it forces them to cut costs. They have spent the last few years attacking the program in the courts, online, and in Congress. As chance would have it, Cassidy became an enemy of the program about the same time his wife bought a lot of stock in Big Pharma.
Because Cassidy is chair of the Senate Health, Education, Labor, and Pensions committee, his opposition to the program could have spelled doom for it. Late last year, he called for a congressional probe into the program, saying, “This investigation underscores that there are transparency and oversight concerns that prevent 340B discounts from translating to better access or lower costs for patients. Congress needs to act to bring much-needed reform to the 340B Program.”
An investigation of 340B is probably unnecessary (to the extent there are a few bad apples in a very large barrel, their identities are already well-known), but one outcome would be what we’ve known all along: it works.
According to healthcare consulting firm Trilliant, “In 2024, 507 out of the 1,779 hospitals evaluated had a negative operating margin but positive net income due to revenue from non-patient-related activities.” A major non-patient-related activity? According to Trilliant, retail pharmacy operations are a big one.
Providing healthcare in rural areas is precarious. Since 2005, 195 rural hospitals have closed, while another 65 have gone through “converted closures,” meaning services have been slashed or eliminated. Of those still functioning, it’s estimated that as many as 40 percent of rural clinics are in danger of closing.
There are approximately 140 hospitals just in Louisiana that actively participate as 340B covered entities – about one-third of the hospitals in the state. Patients who can benefit from 340B’s discounts often see their medication costs plummet, according to one 2024 study, which reported, “At Our Lady of the Lake Regional Medical Center in Baton Rouge, uninsured patients pay an average of just $7.77 for retail prescriptions and $48.05 for specialty medications (compared to non-340B prices of $78.13 and $3,937.10, respectively).”
Around 30 percent of Louisianans live in rural areas, and almost 20 percent of Louisianans live below the poverty level. So it shouldn’t be a surprise that the Louisiana state legislature passed a 340B protection law in 2023, and that law was upheld in appeals court earlier this year.
But Big Pharma doesn’t want to let a little thing like laws and court rulings stand between them and their profits. (Remember, this is the same sector that condemned the whole world to ruin in 2020 so they could become billionaires off the “pandemic.”) Big Pharma has tried to trick Trump voters into opposing the very program that helps them with insinuations that it’s abused by illegal immigrants and the transgender industrial complex. People mostly seem to have seen through the lies, remembering also that Big Pharma is happy to exploit illegal immigrants and profit from transgender mutilations when it suits them.
Rep. Julia Letlow, the Trump-backed candidate, and state Treasurer John Fleming advanced to a runoff that will take place on June 27. One hopes that whoever wins the runoff they will support the 340B program for their fellow Louisianians and the rest of America. Big Pharma would hate it.
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