U.S. Senate Minority Whip John Thune (R-S.D.), a strong 340B covered entity ally, is considering not running for re-election in 2022. | Gage Skidmore/Flickr

John Thune, Senate’s No. 2 Republican and Strong 340B Provider Ally, Weighs Retirement

South Dakota U.S. Sen. John Thune, the second-ranking Senate Republican and a long-time 340B covered entity ally, might not run for re-election in 2022, two news organizations report.  It would be a significant blow to 340B providers who have counted on Thune and his clout over the past two decades.

Thune told a home-state newspaper early this month he would announce his decision by the end of this month. Thune said his wife Kimberley wants him to come home, the Black Hills Pioneer reported. The New York Times reported this week that “a combination of family concerns and former President Donald J. Trump’s enduring grip on the Republican Party” are prompting Thune to consider retirement.

Thune is a senior member of the Senate Finance Committee, which has jurisdiction over the Medicare and Medicaid programs. 340B health systems Avera Health, Monument Health, and Sanford Health are the No. 2, No. 17, and No. 19 employers in the state respectively, according to the Governor’s Office of Economic Development.

Thune and five Senate colleagues introduced bipartisan legislation in this and the last session of Congress to protect hospitals from losing eligibility for 340B drug discounts during the COVID-19 pandemic.

In February 2021, Thune pressed Xavier Becerra during his confirmation hearing to be U.S. Health and Human Services (HHS) secretary to express his commitment to the 340B program.

“To me, the key to 340B is that it enables hospitals and covered entities to provide community benefits that otherwise might not be available. If confirmed, would you commit to ensuring the strength of the 340B program and the community that it supports?”

“Absolutely,” Becerra answered. “Not just in your rural communities, but in the inner cities I’ve had to represent who depend on 340B.”

“Good,” Thune said.

In April 2021, Thune asked Andrea Palm during her confirmation hearing to be HHS deputy secretary how the department would respond to drugmakers denying 340B discounts on drugs dispensed by contract pharmacies and pharmacy benefit managers (PBMs) imposing conditions on 340B hospitals’ drug reimbursement.

Palm answered that she looked forward to ensuring that the program “is working as it’s supposed to be working, and that the oversight and implementation are appropriate so that we really are implementing legislative intent and getting to our safety net providers and low-income communities the access that they need.”

Close Connection to 340B Providers

“Due to South Dakota’s very small population, Senator Thune has a uniquely close relationship with his constituents,” said Ted Slafsky, who was the long-time leader of 340B Health prior to becoming Publisher/CEO of 340B Report. “Every time I accompanied the South Dakota hospitals to visit with the Senator on Capitol Hill, he always took the meeting and knew the names of all the attendees on a first name basis.” This occurred even after the Senator continued his elevation in the Republican leadership, Slafsky said.

“I also recall traveling with the then CEO of Monument Health, the largest health system in the Western part of South Dakota, for a meeting with the Senator at a rural hospital in the Black Hills,” he continued. “It was snowing very hard, and I assumed it would be cancelled. But that certainly was not the case and the Senator stayed longer than I would have expected considering the conditions outside.”