Letter: Health Care Policy for Seniors in need of reform

Louisiana ranks dead last for health care in the country. It’s time for Louisiana leaders to strengthen Louisianans’ access to health care services by ensuring access to affordable, innovative medications and treatments. While Medicare remains one of the most popular federal programs, Medicare health plans do not automatically cover prescription drug out-of-pocket costs, meaning our seniors are affected by policies meant to increase access to affordable drugs. One policy program affecting seniors’ access to medicine is the 340B Drug Pricing Program.

The 340B program was created with the original intent of bringing affordable drugs to patients in need by offering discounts on drugs to qualifying entities, but recent research shows that this intention is not currently being fulfilled. While 340B entities receive up to billions of dollars in profits from manufacturer drug discounts, these entities are not using this money to bring health care access to patients.

To make 340B work for senior patients, one aspect of the program that must be addressed is a requirement for 340B entities to provide charity care. More than half of 340B hospitals provide less charity care than the average U.S. short-term care hospital – and this includes for-profit hospitals.

Like prescription drug coverage, there are medical services that require out-of-pocket costs even when seniors are insured under Medicare, and not all of our seniors can afford these necessary services. Almost 19% of Louisianans are over age 60, and 9% are over age 70. In Louisiana, over 13% of seniors age 65 or older live in poverty, a significantly higher percentage than the national average. Ensuring access to charity care is an important issue for Louisiana if we are to prioritize the health of our seniors.

Veterans, making up a significant portion of Louisiana’s population and the percentage of our seniors, are also affected by 340B’s lack of charity care requirements. Compared to the general non-veteran population, veterans have worse overall physical health, putting them at greater risk of needing charity care services.

Another way to make 340B work for senior patients is to enforce the relocation of 340B contract pharmacies. These pharmacies are services through which 340B entities can dispense discounted program drugs to patients.

Almost all contract pharmacies are located in a different zip code than their corresponding 340B health care entity. In fact, more than half of these contract pharmacies are in zip codes where median income is more than 20% higher than 340B entity zip codes. What this means is that the objective of the 340B program – making medicine accessible to seniors, and all patients in need – is not being realized because patients in need do not live in the areas where 340B medicines are being dispensed. On top of that, more than half of contract pharmacies do not share their 340B savings with patients. Restructuring the role of contract pharmacies within the 340B program would significantly impact our seniors’ access to medicines.

The 340B Drug Pricing Program is the second-largest federal drug program in the country, smaller only than Medicare Part D. Our seniors, along with all patients in need, could rely on this meaningful program to access their prescription medicines if the program followed through on its goals. By making reforms to 340B’s charity care and contract pharmacy requirements, the program can get back to what it was meant to do: bringing care to patients. It is time we make sure this massive program works for seniors, and all patients, who need it.


Conwell Hooper-Executive Director of American Senior Alliance, a not-for-profit organization that advocates on behalf of America’s greatest generation.