Joe Grogan, senior fellow at the USC Schaeffer Center, said on May 19 that the 340B drug pricing program has grown beyond congressional control and called for lawmakers to intervene. Grogan said congressional inaction reflects a failure to address issues in a program originally created by Congress.
“340b is out of control and it's malpractice for Congress having a created a program that is totally out of control to not step in a fix this,” Grogan said on social media.
The 340B program was designed to help safety-net hospitals and clinics serving low-income and uninsured patients by requiring drug manufacturers to sell outpatient drugs at discounted prices. However, questions have been raised about whether those savings are reaching patients or are being used as intended, according to JAMA Health Forum.
Rick L. Callender, an NAACP California/Hawaii State Conference board member, made similar concerns about whether 340B savings are reaching patients, saying the program is failing Californians who rely on it most because discounts are not reflected at the pharmacy counter. He said the program is “most needed in low-income and minority communities,” but argued that large corporations are “siphoning funds from the 340B program to pad their bottom line,” while patients still pay full price. Callender said the program has “strayed far off course” and is “rife with fraud and abuse in California,” according to Golden State Today.
Federal oversight gaps remain a central concern in the 340B program.
According to the U.S. Government Accountability Office, program audits do not fully test whether covered entities prevent duplicate discounts, audit closure processes do not ensure all noncompliance has been corrected, and oversight does not guarantee that only eligible hospitals participate. These gaps affect requirements related to diversion, Medicaid rebates and eligibility.
At an October 2025 Senate Health, Education, Labor & Pensions Committee hearing, Chairman Bill Cassidy said the 340B program had "ballooned with limited oversight," raising questions about how revenue is used and whether it directly benefits low-income patients. Cassidy also pointed to concerns involving contract pharmacies, hospital consolidation, duplicate discounts, and weak transparency requirements.
Joe Grogan served as Assistant to President Donald J. Trump and Director of the Domestic Policy Council, where his portfolio included health care, regulatory policy, economic expansion, commercial space, environment, agriculture, civil rights, and education. He also served as Associate Director for Health Programs at the Office of Management and Budget, overseeing domestic health spending.
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