Joe Cunningham writes for RedState.com about a shift in government policy that could hurt American healthcare.
The Democrats have decided that they want to make the One Big Beautiful Bill their primary campaign talking point in 2026. They think that by focusing on Medicaid cuts, they can scare voters away from the Republican Party and back toward them for the midterms.
One of their focus points is how Medicaid cuts might impact rural hospitals. But the Democrats are also big proponents of doing away with the 340B drug program that those same hospitals rely on, and they aren’t lifting a finger to stop big pharmaceutical companies from trying to gut it however they can.
Five major pharmaceutical companies … are pushing to fundamentally change how rural hospitals get discounted drugs. Instead of getting upfront discounts through the federal 340B program, these companies want to switch to a “rebate model” where hospitals pay full price first, then wait for pharmaceutical companies to maybe pay them back later.
Sound like a scam? That’s because it is.
A new national survey by 340B Health shows just how devastating this change would be. The average critical access hospital—these are the small rural hospitals with 25 beds or fewer that serve communities across Louisiana and the rest of rural America—would have to float an extra $1.7 million per year to pharmaceutical companies.
Think about that for a minute. Rural hospitals that are already operating on razor-thin margins would suddenly have to come up with nearly $2 million in upfront cash, then wait for drug companies to process their rebate requests “using their own criteria and timelines.”
For larger hospitals, the numbers are even more staggering. Disproportionate share hospitals would face an average annual burden of $72.2 million.
But it gets worse. These rebate schemes don’t just create cash flow problems—they dump massive new administrative costs on hospitals that can least afford them.
