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Rural Kansans rightly have real concerns about rural healthcare access. Every night when they sit down to catch up on their nightly news on TV or walk back from their mailbox with an armful of campaign literature, they’re reminded of the debate.
The 340B drug program, originally instituted in 1992, was meant to help rural hospitals reduce medication costs for patients in need. Instead, the program has become a disturbing mess of waste, fraud and abuse and a lucrative slush fund for large corporate hospital systems.
Shockingly, Kansas lawmakers have tried to expand the program under proposals like Senate Bill 284, but were stopped. Similar legislation could be poised to make a return in the upcoming legislative session. Growing 340B would be a terrible mistake without first addressing the program’s widespread corruption, mismanagement, and inefficiencies. Without a full accounting, an expanded 340B will only continue to line the pockets of large, corporate hospitals without addressing the needs of low-income communities it was intended to protect.
Congress created the 340B program to help rural hospitals and clinics stretch limited resources by requiring drugmakers to sell them drugs at a discount. The theory was that hospitals would then pass these cost savings on to vulnerable patients in their communities.
However, the program was based largely on an honor system and suffered from a lack of oversight. Over time, it appears that instead of offering savings to patients, some hospitals are benefitting from discounts and then charging insurers and patients full price, pocketing the difference. Further, investigations have revealed that 340B hospitals are not providing better care to low-income communities.
A few cases in Kansas show just how far the waste and abuse go:
In Topeka, single mother of two Mariana Villegas earned about $14,500 in 2025, qualifying for free care under the policy of Stormont Vail, a hospital that has benefitted from the 340B program. Yet, instead of passing on discounts, Stormont Vail sued her over a medical bill, and roughly a quarter of her biweekly paycheck was garnished. A Kansas-based legal aid group later helped settle her case and ten others involving patients who qualified for financial assistance.
Meanwhile, the University of Kansas Health System takes millions in taxpayer payments under the 340B program. Yet its main hospital earned only a “D” for community benefit from the Lown Institute. Across the state line on the Missouri side of Kansas City, University Health Truman Medical Center earned an “A” on that measure, which gauges hospitals’ investment in free care and community health.
The University of Kansas Health System reports that it spent nearly $714 million in “community care support” in fiscal year 2025. But the report obscures just how much of that money went toward charitable care. Nearly $548 million of that total was accounted for by “Medicaid and Medicare losses.” The remaining $166 million lumps charity care together with education, advocacy and other services.
Wichita-based Ascension Via Christi also benefits from the federal 340B drug-pricing program while paying its last CEO nearly $2 million. At the same time, frontline workers have warned of unsafe nurse-to-patient ratios, weak hospital-wide security, and staffing cuts affecting patient care technicians.
Without more accountability and transparency, the public has no way of knowing whether 340B savings help vulnerable patients, as intended.
The problems extend far beyond Kansas. Just over a year ago, the Congressional Budget Office found that 340B encourages providers to prescribe more medications, including costlier ones, in ways that tend to increase federal spending. Federal auditors have also identified weaknesses in checks on whether hospitals even qualify for discounts. Taxpayers deserve answers – and soon.
Kansas lawmakers should demand a fulsome accounting of the 340B program. Hospital systems seeking state-backed protections meant to help vulnerable communities owe Kansans a public accounting of their 340B savings. Any lawmaker who votes to expand the 340B program and grant those hospitals special privileges should be prepared to explain how Kansans benefit and what consumers get out of the deal.
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