Opinion: Obamacare should be a hand up, not a handout to those in need

In 2012, Nancy Pelosi ominously declared that Congress needed to pass the health care reform bill so the public could find out what was in it. Unfortunately, ever since that fateful day, Americans have been plagued with one bad health care surprise after another.

Millions of people have lost their coverage since the passage of the “Affordable” Care Act (despite President Obama’s promise to the contrary). In addition, it has recently become known that health care premiums are poised for a sharp rise in 2016—again, despite the promises that the President and Democrats made when Obamacare was signed into law. And let’s not forget that a Supreme Court decision in the pending King v. Burwell case might result in the dismantling of federally-run Obamacare exchanges.

It should be obvious that attacking an effective, revenue-neutral program that helps patients in need receive vital medications is just not the best way to address the many issues facing American families when it comes to health care.

— Mario H. Lopez

It is clear that no matter the outcome of the Supreme Court case, Obamacare – as it was conceived – is unlikely to weather ongoing scrutiny. With that in mind, it’s time for a fact-based examination of the health care policies that work (versus those that have utterly failed).

It is strange, then, that out of all the challenges faced by the system, some Republican Members of Congress are turning their attention to a decades-old, cost-neutral health care program that directly benefits patients in need. The 340B drug-pricing program should be a shining example of the way the safety net is supposed to work, yet it is now coming under fire.

The program has been around for over 20 years; President George H.W. Bush signed it into law in 1992 in order to “stretch scarce federal resources” by easing costs for providers who are designated as “critical access.”  Currently, pharmaceutical companies that participate in Medicaid must sell medication to critical access hospitals at a discount. In return for their voluntary participation, companies gain access to millions of customers – and although those customers pay a discounted rate, companies still receive significant payments for their products. In 2012, sales of medications under the 340B program totaled $6.9 billion.

At a time when hospitals (especially those in rural and inner-city areas serving working class patients) are closing their doors at an alarming rate, Republicans should be working to double down on effective health care policies. Savings under the 340B program enable critical access hospitals to serve low-income and underserved patients in need of vital medicines. These “safety net” hospitals are the first line of defense for communities struggling to provide basic health care to their citizens.

At the end of the day, the 340B program allows patients who might otherwise not be able to receive necessary medication to purchase those medications through critical access hospitals – and struggling hospitals that serve at-risk patients are able to keep their lights on and their books balanced. And for those who are concerned with the high cost of health care in America, it is worth stressing that the 340B program is one of the (very few) public health policies that does not cost taxpayers a dime.

New limits on hospital eligibility to participate in the program will restrict patient access and directly harm at-risk patients. And all taxpayers stand to take a hit, as increased Medicare costs that would result from scaling back the 340B program would of course fall on their shoulders.

In addition, more critical access hospitals themselves would face financial burdens that magnify the pressures that have forced many to close their doors. With each hospital closure comes a new community crisis, and the lost jobs and patient access problems that naturally follow. The numbers are staggering: 16 rural hospitals closed in 2014 alone, while from 1970-2010, more than 300 urban hospitals closed in inner cities around the country.

Many of these hospital closures have occurred in areas with significant Hispanic, African American and other minority populations—constituencies with which the GOP should be working to improve, rather than degrade, its standing.

It should be obvious that attacking an effective, revenue-neutral program that helps patients in need receive vital medications is just not the best way to address the many issues facing American families when it comes to health care.

Now more than ever, the American people need effective leadership to help fix our broken healthcare system and the many problems that Obamacare has exacerbated. Republicans should be focused on solving the problems Obamacare created or worsened and ensuring that the safety net serves its intended purpose: as a hand up, not a handout, for those who need it most.