Health care officials and political leaders are worried. A dark money group dropped hundreds of thousands of dollars into a local primary election spreading falsehoods about the lieutenant governor and a program called 340B.
340B is a nearly $50 billion program, but most people know nothing about it. Black lung centers, HIV clinics and sickle cell clinics are supported by this program. It also helps provide reduced or no-cost prescription medicine, like insulin, to people who can’t afford it. In addition to all this, the program helps keep rural health care centers open.
The federal program is more than 30 years old. In 1992, President George H. W. Bush signed 340B into law. The program aimed to keep rural hospitals afloat and help low and middle-income Americans access expensive prescriptions.
State Legislature Addresses Problem
Over the last few years, pharmaceutical companies have stopped sending discounted 340B medicine to all but one pharmacy location. In effect, this forced some patients to drive an hour or more to reach an entity authorized to sell the medicine at a discounted rate.
Sen. Tom Takubo, R-Kanawha, is a pulmonologist and crafted the bill to protect 340B in the state. He said he sees the struggles of patients seeking health care firsthand.
Will Price/West Virginia Legislature
“I have patients that have difficulty with just the gas money to get to their clinic visits, much less to drive long distances to get their prescriptions that keep them alive every month,” Takubo said.
The bill he sponsored passed almost unanimously, and the governor signed it into law.
It fines any pharmaceutical company that fails to send medicines to all 340B contract pharmacies $50,000 dollars a day per prescription.
The Lies Start Flying
But just months later there came a fury of smear campaign ads against 340B and Senate President Craig Blair.
Screenshot of one of the “Stand For Us” Pac campaign ad.
Some ads said things like, “Craig Blair has supported 340B and caved to the far right.” Others linked his support for 340B to supporting free health care for undocumented immigrants.
He said there is zero truth to this.
“Anybody that knows me knows that that is not in my DNA. I wouldn’t be part of it,” Blair said.
The far-right Super PAC, Stand For Us, behind the ads dumped $400,000 of dark money into the race. West Virginia Public Broadcasting has not been able to trace the expenditures or original donors to this PAC.
The ads fused together different issues: 340B and immigration, or 340B and transgender rights. In the eyes of his constituents, this put him on the wrong side of the issues.
Blair lost his bid for re-election.
“There were a lot of lies that were put forward. And then they’ve taken victory laps since then,” Blair said.
The Super PAC put out a press release. It outlined how and why it used disinformation. Then it warned other Republicans.
“Stand for Us isn’t going anywhere, and the results of our efforts have only emboldened us to increase our initial investment,” the group said in a press release. “Republicans are now on notice that they support 340B or non-citizen voting at their own political peril.”
Screenshot of one of the “Stand For Us” Pac campaign ad.
Sen. Eric Tarr, R-Putnam, is part of the state Senate’s leadership. He said the campaign against Blair threatens the health of West Virginians.
“To say that effort was supporting illegal immigration into West Virginia in any way was an outright lie. And they dropped about $400,000 in two weeks to push that lie,” Tarr said.
Will Price / West Virginia Legislative Photography
He said it also poses a threat to the health of the state’s democracy.
“So aside from just the attack on our citizens that need those medications, there was an attack on our elections process and truth in elections,” he said.
Tarr, Takubo and Blair are all considering both legislative and legal courses of action.
Health Care Workers Worry
Aaron Norris is a pharmacist at Mace Pharmacy, in the small Barbour County town of Phillipi. Mace Pharmacy is under contract by a health center that is enrolled in the 340B program.
“340B allows healthcare to come to places where health care would not be,” he said.
Briana Heaney/West Virginia Public Broadcasting
Norris said his community, where 1 in 4 residents live in poverty, relies on the program to receive reduced price medications and health care. The 340B program helps people who make too much to qualify for Medicaid but can’t afford all their health care costs. For example, it would help someone pay for insulin, which can cost thousands of dollars a month even with insurance.
“Patients, that, whenever they look at their insurance, their insurance falls short,” Norris said. “So they say, especially toward the end of the year, ‘I can’t afford to take this medication. So I’ll just go without.’”
340B fills in that gap at the cost of Big Pharma’s bottom line. The federal legislation requires that any medication reimbursed through Medicaid or Medicare also be made available to certain rural or low-income, not-for-profit, health care providers at a discounted rate. The discount can range from 10 to 90 percent. Those providers can then sell the medications at the discounted rate or sell them at the same rate and put the money back into the community in various ways.
Jim Kauffman is the president of the West Virginia Hospital Association. Helping keep many of his not-for-profit hospitals open is one way he says the savings are used in West Virginia.
Kauffman said this disinformation campaign and other opposition against 340B only stand to benefit one group: The pharmaceutical industry.
“If that program goes away, who benefits? Pharma. Who stands to suffer? The local community,” Kauffman said.
Kauffman said the 340B program costs pharmaceutical companies billions of dollars a year in lost profits.
“If I’m not mistaken, when you look at the margins of pharmaceutical companies, they’re doing very, very well.” Kaufman said. “I was just at a hospital yesterday. Their budgeted margin for the year is 1 percent. Most of the hospitals in West Virginia are operating in the red.”
If 340B goes away or sees a seismic contraction then the health care landscape in the state could start to look a lot different Kauffman said.
“If 340B flatly didn’t exist, what you would see is all that savings right now that hospitals, federally qualified health centers, black lung clinics received disappear. Then those community programs that are being supported disappear. And all those dollars go to the bottom line of Pharma,” Kauffman said.
Pharma
A major nationwide pharmaceutical lobby, PhRMA, which said it is not involved with the disinformation deployed against Blair, said there are problems with the rapid expansion of the 340B program and transparency in reporting. Other academics who study health care policy have noted these as flaws of the massive 340B program as well. The group said it could not comment on the disinformation that was sent out in Blair’s primary election.
West Virginia Public Broadcasting reached out for comment from Super PAC Stand For Us, which was responsible for the disinformation used in Blair’s election. No response was received from the group.
The group also worked to pressure the Republican governor of Virginia, Glenn Youngkin, who vetoed a similar bill that was passed into law in West Virginia. In Missouri, the group may have poured millions of dollars into the ongoing Missouri gubernatorial race which has its primary elections on Aug. 6. One of the front runners in that race, Jay Ashcroft, has come out against 340B, echoing falsehoods similar to those spread in West Virginia.
