The 340B Drug Pricing Program was meant to help underserved communities—but is it working?
For Black and Brown communities, the cost of healthcare is more than just dollars—it’s life and death. The 340B program, originally designed to provide discounted medications to hospitals and clinics serving low-income populations, has come under scrutiny for a lack of transparency, accountability, and reinvestment into the communities it was meant to help.
At BlackDoctor.org’s second annual State of Black Health: What Now Black Health Summit, the message was clear: transparency, reform, and reinvestment in Black communities are urgently needed—because healthcare should not be a for-profit industry at the expense of Black lives.
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The panel, “Beyond the Discount: 340B and Black Health Justice”, presented in collaboration with USA TODAY, featured a critical discussion on the failures of the 340B program and its impact on Black health justice. The conversation was moderated by Ebony Curry, Master Journalist, and brought together experts to examine the program’s shortcomings and its disproportionate effects on Black communities.
Meet the Panelists:
- Thomas Johnson, Executive Director of ASAP 340B
- Pamela Price, Deputy Director of The Balm in Gilead
Key Takeaways from the Panel
1. The 340B Program is Being Exploited for Profit, Not Patients
What is the 340B program? It was intended to help hospitals and clinics serving low-income communities by allowing them to buy prescription drugs at deep discounts—with the expectation that the savings would be reinvested into patient care.
However, many large hospital systems have turned 340B into a massive profit center.
Thomas Johnson exposed how hospitals are gaming the system:
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“If you’re able to get your drug at a 50% discount—which is a serious discount for a prescription drug—and the law allows you to resell that same drug for 500% to 1,000% of the cost, you are now gaming the system. The law doesn’t explicitly prevent this, so hospitals have taken advantage.”
Rather than using 340B savings to expand care for the underserved, some hospitals are redirecting funds to wealthier areas, reducing services in Black communities, and making billions in revenue.
Pamela Price highlighted the capitalist reality of healthcare:
“In this country, healthcare is both transactional and a capitalistic adventure. No one is in the healthcare business because they want to save lives. The reality is, most of it is about money: ‘How much is this going to cost? How much will I make?’”
2. Black Communities Are Being Left Behind
A New York Times investigation revealed that Bon Secours Hospital in Virginia took 340B revenue meant for a low-income Black community and used it to expand wealthier suburban facilities.
Price, whose work is rooted in Richmond, VA, confirmed the devastating impact:
“Bon Secours is in our backyard. I know exactly where that campus is, because it’s in Northside Richmond—one of the most impoverished, underdeveloped, under-resourced neighborhoods. Meanwhile, that same year, Bon Secours netted over eight billion in revenue. If you ride through Northside Richmond, you see rampant homelessness, unemployment, and a life expectancy 10 years lower than the neighboring zip code.”
This isn’t an isolated incident. Across the country, safety-net hospitals and clinics that truly serve Black communities are shutting down, while major hospital systems rake in billions from 340B with little to no reinvestment.
Johnson broke it down further:
“Instead of using 340B to serve the most vulnerable, we’ve seen hospitals reduce capacity in underserved areas while expanding in wealthier communities. They charge Medicaid and Medicare five to ten times the drug’s original price—so instead of serving five patients, they serve one. That’s how the system is rigged.”
3. Without Transparency, Patients Have No Power
Beyond reduced services, Black patients in 340B-affected hospitals often face mounting medical debt and limited access to affordable treatment.
Price revealed another dark truth:
“People don’t even know their medical record number is being used to help hospitals get these drug discounts. Yet, they’re still receiving medical debt notifications. So not only are Black patients not benefiting from 340B savings, they’re being burdened with bills.”
This cycle of financial strain and reduced healthcare access has made already devastating racial health disparities even worse.
4. How Can We Fix the 340B Program?
The panelists agreed: without major reforms, Black communities will continue to be shortchanged by 340B.
Johnson laid out three critical actions that must be taken:
- Mandate Transparency – “Hospitals benefiting from 340B should be required to report exactly how they’re using their savings. Right now, there’s no real connection between the patient population and the funds received.”
- Ensure Funds are Reinvested in Underserved Communities – “Clinics in the 340B program already have clear reinvestment rules. Hospitals must be held to the same standard.”
- Hold Lawmakers Accountable – “Congress needs to close loopholes that allow hospitals to profit off of a program meant to serve the poor.”
Price added that the fight for reform starts with awareness:
“We surveyed 500 people and barely 20% had even heard of 340B. That’s a problem. Black communities must understand how healthcare policies impact them, so they can demand change.”
5. The High Stakes: What Happens If Nothing Changes?
If the status quo continues, Black health disparities will worsen.
Johnson warned about a growing crisis in cancer care:
“Hospitals are using 340B to dominate oncology care, pushing out private cancer doctors. This means fewer treatment options for Black patients, in a disease that’s already a leading cause of death in our community.”
Price pointed to medication access as another danger:
“If 340B remains broken, hospitals will continue restricting access to specialty medications. Cancer drugs, HIV treatments, and other critical medicines could disappear from underserved communities altogether.”
Final Thoughts: Fighting for Black Health Justice
The 340B program has the potential to be a game-changer for Black health equity—but only if it’s used as intended.
Right now, billions of dollars are being siphoned away from Black communities, leaving them with fewer resources, more medical debt, and worsening health outcomes.
“We can’t have healthy human beings if they aren’t economically sufficient. If they aren’t educationally sufficient. If they don’t have access to proper care. It’s all connected. And until we fix the root issues, our communities will continue to suffer,” Price added.
The panelists urged Black communities, lawmakers, and healthcare advocates to take action:
- Demand transparency in how 340B funds are used
- Hold hospitals accountable for reinvesting savings into underserved communities
- Educate Black patients about their rights and the policies impacting them
How You Can Join the Fight for Health Equity
Learn more and advocate for reform:
Because at the end of the day, Black health justice is about more than access—it’s about accountability, equity, and the right to thrive.
