That’s why we joined a broad coalition of patient, provider, and community groups in sending a joint letter to lawmakers. Our message is clear: Louisiana should prioritize patient-centered policies that improve affordability and protect access to care.

There are practical steps the Legislature can take right now to move in that direction. Targeted pharmacy benefit manager (PBM) reforms, like those included in SB 337 led by Senator Harris, would increase transparency in the healthcare system, reduce PBM incentives that can drive up costs, and ensure patients can get the medicines their doctors prescribe at a lower out-of-pocket cost.

At the same time, it’s important to approach other proposals with caution. 

Policies that rely on government price-setting, like SB 369, or new bureaucratic boards, like the Prescription Drug Affordability Boards that SB 401 / HB 918 would create to determine what treatments are “affordable,” may sound like solutions, but in practice, they risk limiting access to care or delaying treatment decisions. 

Patients should never be caught in the middle of policies that unintentionally create new barriers. By focusing on solutions that are transparent, balanced, and centered on real patient needs, Louisiana lawmakers can ensure that people across the state can afford their care and access the treatments they depend on.

We encourage you to read the full joint letter to learn more about how Louisiana can put patients first this session.

HB 697 / SB 1158 could make some medicines harder to access if doctors or pharmacies are paid less than what those medicines cost. When that happens, patients may experience non-medical switching, delays, or be sent to higher-cost hospital settings instead of receiving care in their community, increasing system-wide costs. For patients managing conditions like cancer, autoimmune disease, neurological conditions, or rare disorders, even short disruptions in care can be life-altering.

Experience from other countries illustrates these risks. While nearly 90% of medicines launched globally between 2012 and 2021 are available to U.S. patients, access abroad is far more limited, about 48% in the United Kingdom, 24% in Australia, and 21% in Canada, with many patients waiting years longer for new treatments or never gaining access at all.

Lower prices on paper do not guarantee lower costs for patients. Although intended to lower premiums, HB 697 / SB 1158 contains no mechanism to ensure savings reach patients or reduce premiums, and experience shows savings are often absorbed elsewhere in the system.

Thankfully, Florida can pass proven, patient-first options to lower costs without risking access, including:

• Sharing negotiated discounts and rebates with patients at the point of sale
• Ensuring all co-pay assistance counts toward deductibles, and out-of-pocket limits
• Improving transparency and accountability for insurers and PBMs

Read the following joint letter from 34 patient and provider advocacy organizations to learn more about why Florida legislators should oppose HB 697 / SB 1158 and instead prioritize solutions that lower costs while protecting access to the medicines Floridians rely on.

At the heart of the problem? Pharmacy Benefit Managers (PBMs). These middlemen control 94% of prescription drug claims nationwide, and in Louisiana, Express Scripts alone holds 71% of the market. PBMs design formularies that favor expensive drugs, restrict patient choice, and drive up costs—all while pocketing profits.

Congress has the power to fix this. H.R. 4317, the PBM Reform Act of 2025, offers real solutions:

• Ban spread pricing in Medicaid
• Increase transparency
• Break the link between PBM revenue and drug prices
• Ensure rebates go directly to patients at the point of sale

This is a bipartisan issue with broad support. Passing PBM reform before year-end would be one of the most impactful steps Congress can take to make prescriptions affordable for American families.

The 340B program was created in 1992 to help underserved communities by providing discounted medications, but evidence shows it has drifted far from its mission:

• Growth in Wealthier Areas: 60% of 340B sites are in higher-income areas, with program expansion favoring high-income neighborhoods (+5%) while declining in low-income areas (-5.6%).
• Higher Costs Without Benefits: Medicaid spending increased by $32 billion annually (2014–2021) due to 340B growth, yet disparities in care persist. Prescription costs at 340B entities are 150% higher for commercially insured patients.
• Minimal Charity Care: In New Mexico, the charity care rate is just 1.7%, below the national average of 2.5%, while 340B earnings outpace charity spending 4:1.

Expanding the program without addressing these issues will perpetuate inefficiencies, harm local providers, and fail to serve New Mexico’s vulnerable populations.

It’s time to focus on transparency, accountability, and reforms that ensure 340B delivers on its original purpose: improving access and health equity for underserved communities.

Read the joint letter from 10+ patient and provider advocacy organizations to learn more about why reform is essential for New Mexico.

While HB 5350 aims to address healthcare affordability, we believe it is premature. The federal 340B Drug Discount Program, central to this bill, has strayed from its original mission of supporting vulnerable communities. Evidence shows that the program fails to lower costs for patients in need, and its benefits are disproportionately concentrated in affluent neighborhoods, leaving underserved areas behind.

With the program under federal investigation and bipartisan reform efforts underway, we urge Michigan legislators to pause and ensure future actions truly serve the interests of patients.

Let’s work together to ensure every Michigander has access to the affordable, equitable care they deserve.

The 340B Drug Pricing Program, initially created to aid underserved communities, has been found to often fall short of this goal. Instead of providing necessary discounts to Delawareans, it has become a source of significant profit for certain entities and for-profit pharmacies. This has led to increased costs for patients and disadvantaged rural hospitals struggling to compete.

Today in Delaware, there are 142 contracts between Delaware 340B entities and pharmacies nationwide, and only 50% of contract pharmacies are in medically underserved areas.

Comprehensive federal reform is needed to realign the program with its original mission of improving access to affordable healthcare for all in need. While we appreciate the intent of proponents of this bill to improve healthcare access and affordability in Delaware, unfortunately, we feel House Bill 383 is premature.

We cannot expand the federal 340B program until we can be sure the program works as originally intended – to improve access for patients in Delaware.

Presently, of the 142 contracts between Missouri’s 340B entities and pharmacies nationwide, only half of the contract pharmacies are located in medically underserved areas.

While legislative efforts such as Senate Bill 751 aim to address healthcare accessibility and affordability, proceeding with such initiatives without comprehensive federal reform risks premature action. Before any expansion of the 340B program can be considered in Missouri, it is imperative to realign its operations with its initial mission: to ensure equitable healthcare access for all Missourians in need.

The 340B Drug Pricing Program, initially created to aid underserved communities, has been found to often fall short of this goal. Instead of providing necessary discounts to Kansans, it has become a source of significant profit for certain entities and for-profit pharmacies. This has led to increased costs for patients and disadvantaged rural hospitals struggling to compete.

Comprehensive Congressional reform is needed to realign the program with its original mission of improving access to affordable healthcare for all Kansans. Supporting protections against 340B abuse in the Kansas State Legislative budget is a critical step in this process.

H.E.A.L.S. of the South joined 15+ organizations in the state are appreciative of the addition of protections against 340B abuse in the omnibus budget bills.

We cannot expand the federal 340B program until we can be sure the program works as originally intended – to improve access for patients in Kansas.

Recent investigative reports, including a notable piece by the New York Times, shed light on how certain entities have exploited the 340B Program, prioritizing financial gains at the expense of community service. This exploitation has led to a detrimental impact on healthcare access, particularly in impoverished and underserved areas, contradicting the program’s initial mission. Oklahoma faces similar challenges, with over 20% of its residents lacking health insurance, necessitating urgent attention to these proposed bills.

We cannot expand the federal 340B program until it works as originally intended. We hope Oklahoma legislators will instead ensure patient access to a full range of therapeutic options by supporting House Bill 3368 that would curb harmful practices, like Alternative Funding Programs, and supporting House Bill 2853 to directly lower out-of-pocket costs for patients, like sharing the significant discounts and rebates insurers and PBMs pocket as profit with patients at the point-of-sale.

The federal 340B program, designed to serve the needs of low-income and uninsured patients in local communities, requires extensive reform at the federal level to return the program to its original intent. A recent investigative report by the New York Times underscored how the program has been exploited by certain hospitals and pharmacies, prioritizing financial gains over community service. The unintended consequence has been a negative impact on healthcare access, particularly in impoverished and underserved areas, a stark contradiction to the program’s original purpose. In Mississippi, there are 63 340B hospitals – and 40% of Mississippi’s 340B hospitals are below the national average for charity care levels.  

Mississippi ranks last, or close to last, in almost every leading health outcome. We encourage the Mississippi State Legislature to pass healthcare reforms that will directly lower out-of-pocket costs for all patients, like sharing the significant discounts and rebates insurers and PBMs pocket as profit with patients at the point-of-sale. 

Together, we can improve healthcare in Mississippi.