Health care ‘reform’ misses the problem

Gov. Pritzker should veto HB2371 and HB4327 and instead pursue reforms that ensure transparency is meaningful protected Illinois families from unnecessary health care costs.

While supporters describe these bills as efforts to protect the federal 340B drug discount program, they would further expand a program that lacks accountability while potentially increasing costs for Illinois workers and families.

The 340B program was created to help safety-net providers serve vulnerable patients. But as the program has grown dramatically, so have questions about whether the discounts are reaching patients or simply generating revenue for hospitals and contract pharmacies. Despite the billions of dollars flowing through the program each year, there is no requirement that many covered entities pass savings directly to patients.

Illinois lawmakers acknowledge the need for greater transparency through HB4327, which directs the state to examine how the program operates and its impact on public health care spending. Yet transparency alone is not enough. An audit that simply gathers information without providing meaningful oversight or reform does little to address longstanding concerns about accountability and rising healthcare costs.

At the same time, HB2371 would further entrench contract pharmacy arrangements before policymakers fully understand their impact. According to IQVIA, Illinois accounted for more than $1.8 billion in 340B discounted drug purchases in 2023. As the program continues to expand, employers and working families ultimately bear the cost through higher insurance premiums, increased health care spending and a less transparent pharmaceutical marketplace.

Illinois should not expand and protect a rapidly growing program before determining whether it is delivering value for patients. Passing these bills together puts the cart before the horse: lawmakers are strengthening and codifying contract pharmacy arrangements before they have meaningful answers about the program’s impact on patients, employers, taxpayers, and the broader healthcare system. Accountability should come before expansion — not after it.

Shawn Gremminger, CEO

National Alliance of Healthcare Purchasers Coalition

Washington, D.C.