In a major blow to the 340B provider community, U.S. Rep. David McKinley, the leading voice for the 340B program in the House Republican caucus, was defeated Tuesday in the West Virginia Republican primary. McKinley will remain in office until the end of the year, but his influence will likely wane.
McKinley’s loss to fellow incumbent Rep. Alex Mooney is a major setback for backers of bipartisan bills to expand rural hospitals’ access to 340B drug discounts on orphan drugs and to protect all entities from discrimination by pharmacy benefit managers (PBMs). McKinley also helps lead bipartisan congressional opposition to drug manufacturers’ conditions on 340B pricing when entities contract with outside pharmacies.
Key Player on Important Congressional Committee
McKinley has a senior position on the powerful House Energy and Commerce (E&C) Committee. The E&C Committee is responsible for overseeing and making changes to the 340B program. Under GOP control, McKinley fought back against efforts by drug manufacturers and key Republican committee allies to shrink the program and add additional restrictions. A significant number of E&C Republicans would like to water down the 340B program, but they have not been successful due to resistance from McKinley and few other Republican lawmakers. Democrats are largely supportive of keeping the program as is and have not made efforts to curtail the program.
If the 340B orphan drug and anti-discrimination bills are not passed by the end of this Congressional session, new Republican lead co-sponsors would have to be recruited to take his place. The fact that this is an election year, when getting anything through Congress is harder, lengthens the odds of either of those bills being passed and becoming law during the 117th Congress.
McKinley and Mooney were forced to run against one another in a district that was redrawn because West Virginia lost a House seat due to reapportionment. Mooney was endorsed by ex-President Donald Trump and beat McKinley by a wide margin.
“I’m proud that I have always stood up for what’s right for West Virginia—even when it hurt me politically,” McKinley said in his concession speech, the Associated Press reported. “The groundwork we have laid over the last 12 years has paved the way for a more prosperous and diverse West Virginia economy.”
McKinley, a House member since 2011, was referring to the political cost of his decision to break with his party and vote for the Biden administration’s $1 trillion bipartisan infrastructure law last November. Trump endorsed Mooney on the day Biden signed the bill into law. Trump also criticized McKinley for being one of a group of House Republicans who supported the creation of a 9/11 style bipartisan commission to investigate the Jan 6., 2021, attack on the U.S. Capitol.
Joe Manchin, West Virginia’s popular conservative Democratic U.S. senator, endorsed McKinley this month. Sen. Shelley Moore Capito (R), a 340B supporter, remained neutral in the primary.