Sen. John Kennedy (R-La.) has introduced legislation to preserve the Trump administration’s controversial requirement that community health centers pass along all their 340B savings on insulin and EpiPen-like devices to low-income, uninsured, and/or underinsured patients.

GOP Senator Files Bill to Preserve Trump’s 340B Insulin/EpiPen Mandate

A Republican U.S. senator on an important health care spending committee wants Congress to pass a law preserving the Trump administration’s controversial requirement that community health centers pass along all their 340B savings on insulin and EpiPen-like devices to low-income, uninsured, and/or underinsured patients.

Sen. John Kennedy (R-La.) filed his proposed Vital Medication Affordability Act, S. 2814, on Sept. 23. Kennedy, who is known for his witty and often caustic one-liners, sits on the Senate Labor, Health and Human Services, and Education appropriations subcommittee.

“Hundreds of thousands of Louisianians rely on lifesaving medications like insulin and epinephrine, and 12 percent of adults in our state have diabetes,” Kennedy said in a news release. “Our people need access to affordable medications, especially when our state is recovering from historic storms.” He said his bill would “ensure that key health centers pass along discounts on insulin and epinephrine to patients.”

Kennedy simultaneously introduced a second bill to preserve a different Trump administration initiative to lower the cost of insulin to patients. It would make permanent a Centers for Medicare & Medicaid Services experiment that reduces Medicare Part D beneficiaries’ out-of-pocket costs for insulin to no more than $35 for a 30-day supply. The Part D Senior Savings Model began on Jan. 1.

The Biden administration is expected soon to rescind ex-President Trump’s 340B health center insulin and epinephrine pricing mandate. Almost immediately upon taking office, the new administration froze the previous administration’s final rule limiting what 340B health centers can charge patients for insulin and EpiPen-type devices.

President Trump and his health secretary Alex Azar—the latter the former president of insulin manufacturer Lilly USA—pitched their rule as a response to the high cost of insulin and EpiPens. Health centers have lobbied hard against Trump’s rule. They say it doesn’t address why the price of insulin and EpiPens have increased so much over the years and ignores that centers routinely give the medicines to patients for free or at an affordable price.

“We share Senator Kennedy’s goal of ensuring that patients everywhere can afford the pharmaceuticals they need, including insulin and EpiPens,” said Michael Andry, board chair of the Louisiana Primary Care Association. “However, the policies contained in President Trump’s executive order and Senator Kennedy’s bill reflect fundamental misunderstandings of how FQHCs and 340B operate, and if implemented would do significantly more harm than good for underserved patients. We welcome opportunities to discuss with Senator Kennedy effective strategies to increase access to affordable drugs for all underserved populations.”

“Health centers share the goal of ensuring that all individuals can afford their prescription medications, regardless of their ability to pay, and are required to reinvest savings from the 340B program into patient care,” said Joe Dunn, senior vice president of public policy and research at the National Association of Community health centers (NACHC). “We welcome the opportunity to work with Senator Kennedy to educate him on the health center mission to provide high quality and affordable primary and preventive care, which includes access to affordable medications like insulin and EpiPen.”

Kennedy filed S. 2814 on the same day that another GOP senator, Mike Braun of Indiana, introduced legislation to let the federal government audit 340B covered entities to determine how they use net income from drugs bought under the 340B program.

Earlier this month on the House side of Capitol Hill, the Democratic controlled Energy & Commerce Committee declined to consider GOP-filed amendments to budget legislation that would have

  • Imposed additional sanctions on 340B covered entities for noncompliance after receiving adverse audit findings related to duplicate discounts or drug diversion
  • Required 340B disproportionate share (DSH) hospitals to limit the price of insulin or EpiPen-like devices to “consumers” to the difference between the drug’s average manufacturer price and Medicaid rebate percentage
  • Extended the 340B duplicate discount prohibition to a proposed expansion of Medicaid
  • Protected DSH hospitals from losing their 340B eligibility during the COVID-19 pandemic due to changes in patient and payer mix, but only if they limited the price of insulin and EpiPen-like devices to consumers to the difference between the drug’s average manufacturer price and Medicaid rebate percentage.
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