Last year, over 116,000 Nebraskans accessed health care at a Federally Qualified Health Center. Medical, dental, behavioral health and supporting services like transportation and interpretation services are available at all seven Nebraska health centers.

Some health centers offer in-house pharmacy services while others rely on partnerships with outside pharmacies. Each health center is committed to providing high quality, integrated health care that is responsive to community needs. Collectively, health centers comprise one of the largest systems of primary care in Nebraska; and that system of care ensures access for everyone, regardless of insurance status or ability to pay. Nearly all health center patients are low income, and one-third are uninsured. Federally Qualified Health Centers are the primary care safety net in the state.

Health centers rely on a combination of funding sources to ensure accessible health care. From private insurance to grant funding, health centers braid together multiple funding sources to provide affordable, accessible care for their patients. The 340B program plays a vital role in allowing health centers to stretch their scarce resources and ensuring that vulnerable populations have access to affordable medications. The 340B program was established 30 years ago and allows health care entities to purchase outpatient drugs from pharmaceutical manufacturers at discounted prices. These savings are passed along to patients through significantly reduced drug prices and are invested in programming that expands access to health care across the state. These savings come directly from pharmaceutical manufacturers. No government funding is used in the 340B program.

However, recent proposed changes and restrictions from pharmaceutical companies threaten to undermine the 340B program’s effectiveness and limit access to these medications. Pharmaceutical companies are restricting the ability of health care providers to contract with pharmacies to dispense 340B medication, severely limiting access for patients. These restrictions on contract pharmacies are crippling health center programs and limiting accessibility for patients.

But 340B restrictions don’t just harm health centers and their patients; many independent pharmacies, especially in rural areas, rely on the partnership between the health center and pharmacy. In some rural areas, patients drive as far as three hours each way to access care. Can you imagine having to drive three hours just to get a prescription because of limitations on the 340B program? That is the reality of the 340B restrictions the pharmaceutical companies have put in place. It isn’t just rural communities in Nebraska — all seven Nebraska health centers rely on contract pharmacies to expand access for patients.

Nebraska has a chance to preserve the true intent of the 340B program through Legislative Bill 984, introduced by State Sen. Brian Hardin, by prohibiting restrictions on the use of contract pharmacies. Two states — Arkansas and Louisiana — have successfully passed similar legislation, and 20 other states are currently pursuing similar legislation.

Pharmaceutical companies claim that the 340B program is being abused and that health care providers are making a profit off the program. This is simply untrue. Health centers reinvest every penny of 340B savings into services and programs for patients. Pharmaceutical companies claim that there is little evidence that patients benefit from the 340B program. Behavioral health services, in-home case management, diabetes education programs and low or no-cost prescription drugs are just a few examples of services funded through 340B savings.

Pharmaceutical companies also claim that access to the 304B program isn’t a state issue. On March 12, 2024, the 8th U.S. Circuit Court of Appeals rejected the assertion that federal law prohibits states from taking legislative action on the 340B program. By upholding the Arkansas law prohibiting restrictions on contract pharmacy use, the 8th Circuit Court affirmed that states do hold an interest in and the authority to regulate the practice of pharmacy, including the 340B program.

The State of Nebraska has a fundamental responsibility to care for the health and well-being of its citizens. We cannot stand by and watch the 340B program be slowly dismantled and see patients put at increased risk.

It is crucial that policymakers prioritize the needs of vulnerable populations in Nebraska and take decisive action to protect and strengthen programs like 340B. By preserving the integrity of the 340B program, we can continue to leverage cost savings to expand services, enhance patient support programs and invest in critical community health initiatives. I urge full support of LB 984 and encourage Nebraska to take decisive action to ensure its passage.

Amy Behnke is the chief executive officer of the Health Center Association of Nebraska. Prior to joining HCAN, Amy practiced law at a firm in Omaha, following her service as legal counsel to the Judiciary Committee of the Nebraska Legislature.

This story was originally published by Nebraska Examiner, an editorially independent newsroom providing a hard-hitting, daily flow of news. It is part of the national nonprofit States Newsroom. Find more at nebraskaexaminer.com.