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    States Progress on Contract Pharmacy Protection Legislation

    April 22, 2024

    The Mississippi Capitol Building in Jackson, MS

    Despite 340B Opponents’ Unprecedented Tactics, Many States Progress on Contract Pharmacy Protection Legislation

    By Ted Slafsky

    After over 30 years of working in Washington, D.C., I have become accustomed to the expression “politics ain’t beanbag.” The phrase, as the Christian Science Monitor explains, means “life is rough; get over it” to someone who receives bruising treatment from opponents, critics or the media. A beanbag doesn’t hurt when you get hit by one.

    During my days as a 340B advocate, I experienced my share of difficult battles fighting in the trenches to protect the 340B program. However, the latest efforts to undermine the program have hit a new low.  Earlier this year, a dark money group that most recently orchestrated a pro-tobacco campaign effort released an advertising and media outreach campaign attempting to tie the 340B program to the nation’s immigration challenges.  

    Orchestrated Campaign

    As we first reported in 340B Report, a 501(c)(4) non-profit calling itself Building America’s Future (BAF) released an ad in February titled “Healthcare for Illegal Immigrants.”

    In an ominous tone, with video images of activity allegedly being conducted by immigrants lacking permanent legal status, the announcer says: “The border is broken. Millions illegally pouring into our country. But it’s not just the border: Your tax dollars are at work for illegal immigrants. The more we look, the more we find…And free healthcare? They’re using a program currently under investigation called 340B to launder your money and provide free healthcare for illegal immigrants. The more we look, the more we find. We need Republicans to stand up for us.” 

    The ad appeared on various social media sites and reportedly aired in West Virginia as the state legislature and governor worked on a bill to restore access to 340B discounts in the contract pharmacy setting.

    At the same time, conservative news outlets published articles and posted comments on social media raising similar concerns about the 340B program. They reported on a poll that supposedly found Republican voters opposed any improvements to the 340B program.

    The Tyson Group polling reportedly found that 80% of likely Republican primary voters opposed states strengthening the 340B program and expanding access to subsidized health care for people living in the country illegally, with 73% strongly opposing it, according to the articles, which lacked 340B providers or advocates’ perspectives.  It also did not include the specific questions that were asked to voters.

    The conservative outlet Breitbart News prominently featured the 340B survey in a March 4 article about the highly publicized murder of 22-year-old Georgia nursing student Laken Riley, who was allegedly killed by a 26-year-old man from Venezuela living in the U.S. illegally.

    The Florida-based Tyson Group did not respond to 340B Report’s questions about the polling, including who funded the survey.

    Days later, more conservative news stories came out specifically targeting Gov. Glenn Youngkin (R-VA), who was weighing a decision to sign a 340B contract pharmacy access bill that had easily passed both chambers of the Virginia Legislature.

    The coverage, which attempted to link 340B to the immigration crisis, included a Sinclair Broadcasting article stating that “[w]hile 340B was originally intended to aid facilities that routinely cater to low-income patients, some healthcare providers have begun using the savings to provide care to undocumented migrants.” It continued: “GOP voters in Virginia now say they will hold Gov. Youngkin responsible if a bill like S.B. 119 is signed into law.”

    It would be tempting to ignore or dismiss the effort as a cynical or laughable stretch to tie 340B to the contentious issue of immigration, but unfortunately the strategy actually has been somewhat effective. 

    Despite passing the Virginia Senate by a 40-0 margin and the Virginia House of Delegates by a 92-5, Youngkin recently amended the bill that would have prevented drug manufacturers from restricting 340B pricing to grantees and their pharmacy partners.  When 340B Report and other news outlets asked for comment on Youngkin’s amendment, spokesperson Christian Martinez said the governor “is deeply concerned about the federal 340B program and how it could be exploited to provide taxpayer subsidized healthcare to illegal immigrants.” 

    Youngkin’s amendment would postpone enactment of the contract pharmacy bill for another year and would require the legislature to again vote again on the measure. The amendment also would add new reporting and oversight requirements on 340B providers.

    After Youngkin’s move, BAF ran a new ad urging Republican leaders in Kansas, Mississippi and Missouri to “follow Youngkin’s lead” and reject 340B legislation.

    The fate of Virginia’s contract pharmacy law remains in doubt. The Virginia Senate rejected the governor’s amendment on April 17 by a narrow 21-19 margin (with all Democrats opposing the amendment and all Republicans supporting it.)

    My colleague Will Newton reported that since lawmakers did not override the amendment by a two-thirds majority, Youngkin can now decide whether to sign the original bill, allow it to take effect with his amendment or send it back to the legislature with new amendments or a veto.

    Other States Staying Strong

    On the positive side, many states are not buckling under the dark money pressure campaign. West Virginia and Mississippi recently followed Arkansas and Louisiana’s lead in enacting 340B contract pharmacy protection laws, and Kansas and Maryland are poised to soon enact similar bills.

    As Terrence Shirley, CEO of the Community Health Center Association of Mississippi, aptly said: “In spite of all the negative and untruthful media and print ads being shown and disseminated, I’m very pleased that both the legislative and executive branches of government of the state of Mississippi provided overwhelmingly bipartisan support for this critical piece of legislation. This legislation helps keep the clinic doors open and access available to patients.” 

    What’s my advice to 340B providers in other states trying to pass similar laws? Don’t give up! If your legislature has declined to move forward on a contract pharmacy access law, push your lawmakers and governor to go back into session to get this matter addressed expeditiously.  Despite some hope that Congress will address the matter later this year, I would not count on it.



    Ted Slafsky is the Publisher and CEO of 340B Report, the only news and intelligence service exclusively covering the 340B program.  Slafsky, who has over 25 years of leadership experience with the 340B program, is also Founder and Principal of Wexford Solutions.  Ted can be reached at

    Disclaimer: The views and opinions expressed in this blog are those of the authors. They do not necessarily reflect the official policy or position of any other agency, organization, employer, or company.