As a new Congress and Administration begin a dizzying series of initiatives, health centers and others participating in the federal 340B drug discount statute understandably crave predictions regarding 340B's future. Not only has there been no tangible information regarding the intentions of the Administration or Congress regarding 340B, to the contrary—among the Administration's first actions was to impose a ban until February 1 on most external communications by the operating divisions of HHS until such communications can be approved by a presidential appointee. A separate Executive Order imposes a pause on the distribution of all federal grant funds until DOJ and Homeland Security can audit those grants "to ensure that such agreements conform to applicable law and ... that they do not promote or facilitate violations of our immigration laws" by "supporting or providing services, either directly or indirectly, to removable or illegal aliens." How long will such a pause continue, and by what criteria will DOJ and Homeland Security review federal grants? No one knows.
In any moment of upheaval and uncertainty, there are also important opportunities to educate and inform. Pausing all HHS communications for political review and approval freezes essential communications that facilitate the health care, public health, and safety of hundreds of millions of Americans and affects trillions of dollars in essential benefits and programs. Freezing essential federal grant funding for indefinite and ill-defined audit and review—by agencies not responsible for the grants—holds hostage the programs, like health centers, upon which tens of millions of Americans regularly rely. The same holds true for 340B: the new Administration will have the opportunity to learn how a statute that involves no taxpayer dollars helps facilitate essential public health services for the most vulnerable Americans. Rather than hide heads in the sand or take to the streets, health centers and other 340B covered entities must seize this opportunity to educate the new Administration and Congress how 340B aids Americans—their constituents—and deserves their support.
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