Federally qualified health centers (FQHCs) are the linchpin of our nation’s health care safety net, serving as health care homes for nearly 30 million people every year. These characteristics were part of the program’s original design. In order to qualify for section 330 community health center grant funding from the federal government, health centers must commit to serving all individuals in their service area, regardless of insurance status or ability to pay. Part of the health center model is to help connect their patients and community with enabling services and a variety of supports to ensure ongoing access to quality health care, which is often accomplished by providing those services on a sliding fee scale. For millions of Americans every year, their community health center is their lifeline—providing services irrespective of their employment status, insurance status, or current financial situation. While the health center program expanded with investment from the Affordable Care Act, the current reach of community health centers would not be possible without the 340B program.
In today’s health care environment, FQHCs depend on the 340B program to meet their mission, putting every dollar received back into the communities they are serving. Numerous external evaluators have found that payer reimbursement rates consistently fail to cover the cost of the comprehensive services provided in the community health center environment. In fact, when Congress created the program in 1992, they recognized this reality – that the 340B drug pricing program would allow these providers to “stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.” By allowing the purchase of drugs at a discounted price, the 340B program enables health centers to serve more patients, at a higher level of complexity, than they otherwise could.
Effectively, health center use and engagement in the 340B program exemplifies the intent behind its creation: to maximize federal investment and expand care to underserved communities as effectively as possible.