The Express: Put Pennsylvania’s healthcare first: Reform the 340B program

By Jennifer Riley, Patients Come First Pennsylvania’s Executive Director

In healthcare, patients should always come first. For rural Pennsylvanians, this principle is not just a slogan–it’s a lifeline. Nearly one-third of the state’s population, approximately 3.4 million people, resides in rural areas where access to care presents significant challenges. Healthcare challenges for our rural population can be as simple as transportation. Rural residents often travel long distances to see doctors–up to 3.8 times further than urban residents.

Access to healthcare is further hindered by a shortage of physicians. Rural Pennsylvania had just one primary care physician for every 523 residents, compared to one for every 216 residents in urban areas. Rural counties also have fewer hospital beds, and eight rural counties lack a hospital entirely.

These items contribute to significant healthcare disparities in our rural communities. According to the National Health Council, Pennsylvanians who live in rural areas experience higher rates of chronic disease than their urban counterparts. For people living in rural areas, the odds of dying prematurely from chronic illness are also significantly higher.

There have been efforts to mitigate the healthcare challenges that our rural families face. Programs like the 340B Drug Pricing Program were created to alleviate some of these burdens, as the program was designed to ensure that vulnerable patients can afford the medications they need. Unfortunately, due to the structure of the program, it has strayed from its original mission of putting patients first.

The 340B program allows healthcare providers to purchase medications at deeply discounted rates, with the expectation that these savings are passed on to patients through reduced medication costs and expanded healthcare services. However, too often, rural residents see little to no benefit. Some hospitals and healthcare systems divert these funds to other priorities, undermining the program’s intent to prioritize patients’ health and financial well-being.

Rural Pennsylvanians are disproportionately affected by this misuse, as poverty and poor health outcomes are closely intertwined. Limited financial resources significantly hinder access to adequate healthcare and necessary treatments, making it more challenging for individuals to manage chronic diseases. This financial disadvantage not only exacerbates existing health issues but also creates a cycle of poor health and poverty that can span generations, where children grow up in an environment where healthcare is scarce and unaffordable. In fact, poverty rates are higher in rural areas, with 12.9% of rural Pennsylvanians living in poverty.

Addressing the systemic challenges that our rural communities face requires targeted action and a renewed commitment by our leaders. Restoring the 340B program’s mission by bringing transparency, regulations, and accountability is essential to protecting all Pennsylvanians. Policymakers must require healthcare providers to report how 340B savings are used, ensuring funds directly benefit patients by lowering medication costs and improving access.

Read the full op-ed in The Express here.