Iowa has 82 Critical Access Hospitals, the second highest in the nation. Critical access hospitals (CAHs) are healthcare facilities that offer inpatient, outpatient and emergency services. Located mostly in rural areas and typically have a maximum of 25 beds. A high percentage of these hospitals in Iowa face the possibility of closure.

With just over 37 percent of Iowa’s population living in rural areas, these hospitals are, for many Iowans, their only nearby access to medical care. These hospitals are operating on tight margins and one way they are able to keep their doors open is because of a program called 340B.

This program has been around since 1992 and allows these hospitals to provide medications at a discount to patients that can’t afford them. It works by urging the drug manufacturers to sell these treatments at a discounted rate.

If drug manufacturers do this, then they can also sell their drugs in the very profitable Medicare and Medicaid program. If they don’t, they forfeit access to those markets but can continue their trend of charging whatever prices they think average Americans will pay.

The best part about 340B is it doesn’t cost taxpayers a dime. Yes, you heard that right: a federal program that lowers costs for Iowans that doesn’t cost taxpayers anything. The providers use the savings from the 340B program to pay for care (that is not limited to just medications) that patients in these areas need but can’t always afford.

As you might imagine, the major drug companies hate this program and have made it a top priority to “reform” it (swamp speak for crippling or eliminating it). They sue to try and eliminate it and spend hundreds of millions in lobbying to influence legislators to do their bidding.

Here in Iowa, we’ve passed legislation to protect the 340B program from the drug companies’ routine attempts to dismantle it. We need our representatives in Washington, D.C. to do the same.

It’s rare that a policy really is as simple and straightforward as it seems: drug makers are required to offer the discount, the provider passes the discount onto the patient, the patient can afford necessary care as a result, and none of the burden falls on the taxpayer. Upending this program would mean the burden goes from the drug manufacturers onto the hardworking American taxpayer.

Sometimes policies like this can have an enormous impact on our lives. Hospital closures, a potential bailout of hospitals, medications becoming out-of-reach for our rural friends and neighbors — these are all big real-world impacts.

This is why we have representatives in Washington. We need to encourage them to stand up for us and against the drug companies on this important issue.

——-

Brett Barker, a Republican from Nevada, represents District 51 in the Iowa House.