Federally qualified health centers help Merced patients with medication costs

More than 26 years ago, Congress added a minor provision to the Public Health Services Act to aid nonprofit hospitals, clinics and health systems serving a burgeoning population of low-income and uninsured patients. At the time, these nonprofit health-care providers used their limited resources to pay for medications needed by patients frequenting their emergency rooms.

Working men and women who were uninsured and could not afford to fill or refill their medications, and poor people whose Medicaid coverage offered only limited prescription drug coverage, were desperately trying to manage chronic illness with insufficient means. They found themselves frequent visitors of nonprofit hospital emergency departments.

The 340B provision, a small, but highly influential component of our nation’s health-care safety net, was created to ensure these patients with complex medical conditions would receive their medications without fear of cost or other barriers.

Today, this program finds itself smack in the bullseye on the dartboards of advocates and many pharmaceutical companies.

The advocates want the program left alone, arguing that it is working. The pharmaceutical companies, on the other hand, argue that the program is severely flawed. Both are correct.

Through this program, millions of patients receive help through the lowest drug price or copay of any federal program. For those who cannot afford their medications and who have an income of 200 percent of the federal poverty level or below, prescriptions cost little to nothing. This keeps patients from making unnecessary visits to hospital emergency departments because they cannot afford to fill or refill a medication.

However, the 340B program is also helping nonprofit hospitals generate new revenue sources. Whether these funds are passed on to help patients with the cost of medication is questionable.

Compounding the problem is that with the passage of the Affordable Care Act (Obama Care), the 340B program was expanded. The number of pharmacies allowed to participate in the program has grown from roughly 1,300 in 2010 to more than 28,000 this year.

While patients benefit every time the 340B program is expanded, the real winners have been chain drug stores such as Walgreens and CVS, and supermarket chains with pharmacies built inside, who have all figured out how to turn a small, but robust, federal program into an economic boom.

Lost in the current debate is any mention of patient needs.

A bipartisan Congress and the White House have failed to legislatively address the short and long-term problems facing this program. The 340B program screams for regulatory reform, but no one is listening. Regulatory reform means change and addressing the concerns from advocates and others will take the courage to admit the program is less than perfect.

The saving grace is that Federally Qualified Health Centers (FQHCs), America’s safety-net health-care providers, are helping patients obtain their needed medications.

In Atwater, where the Castle Family Health Centers serve thousands of patients every month, patients with limited income or no ability to pay for their medications know they will always be helped. Ed Lujano, the CEO of Castle, shared the following:

“Castle Family Health Center has a robust 340B program. Any money made is immediately reinvested into ensuring that eligible uninsured patients (with incomes under 200% of the federal poverty level) who cannot afford their medications receive them at minimal or no cost. Our goal: making sure the patient never needs to present at a hospital emergency department because they could not afford their medication.”

Ed Lujano is just one example of what Federally Qualified Health Center leaders are doing across rural California. They continue to reinvest their 340B dollars to helping people in need. FQHCs are not just America’s health-care safety net; they are the only place someone can go and never be turned away.

Ed Lujano and his colleagues across rural California are heroes. In the end, they, at least, are all about the patient.