MATSUI INTRODUCES BIPARTISAN LEGISLATION TO PROTECT PATIENT ACCESS TO AFFORDABLE MEDICATIONS

The following information was released by the office of California Rep. Doris Matsui:

Today, Congresswoman Doris Matsui (D-CA) and Congressman Tracey Mann (R-KS) introduced the bipartisan Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act, legislation to stop pharmacy benefit managers (PBMs) and health insurers from exploiting the 340B Drug Pricing Program at the expense of patients and safety-net healthcare providers. Additionally, the PROTECT 340B Act creates a third-party clearinghouse for duplicate discounts and ends the 340B Rebate Model Pilot Program.

"The 340B program was created to ensure that patients, hospitals, and health centers have access to discounted medicines, not pad the profits of pharmacy benefit managers and insurance companies," said Congresswoman Matsui. "When these companies take advantage of 340B, they're taking resources away from patients who need access to care the most. My bill puts a stop to these unfair practices and protects the care Sacramento families and Americans across the country depend on."

Last year, the 340B program allowed safety-net hospitals, local health centers, and other eligible entities to purchase $100 billion in discounted outpatient medications, helping them stretch limited resources to serve patients in underserved communities. Yet discriminatory reimbursement rates, fees, and restrictions imposed by PBMs and insurers threaten to divert resources intended for patient care into the pockets of healthcare middlemen. The PROTECT 340B Act would:

Prohibit discriminatory PBM insurer practices: Prevent lower reimbursement rates, unfair fees, restrictive pharmacy network requirements and other discriminatory conditions imposed solely because a provider or pharmacy participates in 340B. The protections would also extend to Medicare Part D and Medicare Advantage.

Strengthen accountability and enforcement: Authorize civil monetary penalties of up to $5,000 per violation per day for PBMs that violate the law.

Prevent Medicaid duplicate accounts: Establish an independent, centralized process to identity and resolve duplicate discounts while protecting confidential claims data and allowing providers to submit information retrospectively.

End the 340B Rebate Model Pilot Program: Require the Department of Health and Human Services (HHS) to terminate the pilot program and prohibit the establishment of a similar program.

"The 340B Drug Pricing Program is an essential tool to not only provide affordable, life-saving medications for struggling Californians, but also to support their healthcare in many other ways," said Jenny Nguyen, Vice President, Financial Policy, California Hospital Association. "Here in California, 340B has a meaningful and positive impact by helping provide: free health screenings for low-income and unhoused Californians, emergency financial aid for children and families, community health education programs, and much more. Congress should do all it can to preserve the 340B program and the support it provides every day for Californians in need."

"The 340B program is vital to Community Health Centers (CHCs) and the 52 million people 1 in 7 Americans, including 1 in 3 in rural communities who rely on them for affordable, comprehensive and effective care," said Kyu Rhee, MD, MPP, President and CEO of NACHC. "By ending the rebate model and prohibiting discriminatory actions against covered entities and their pharmacies, the PROTECT 340B Act helps ensure 340B savings stay with the patients they were intended to help and continue to support access to affordable, life-saving medications for the patients we serve. We are grateful to Congresswoman Doris Matsui and Congressman Tracey Mann for their bipartisan leadership on this important legislation. We look forward to working with them and Members of Congress on both sides of the aisle to advance legislation that protects and strengthens the 340B program for CHCs and their patients."

"We thank Representatives Matsui (D-CA) and Tracey Mann (R-KS) for reintroducing the Preserving Rules Ordered for The Entities Covered Through (PROTECT) 340B Act of 2026," said Samuel V. Calabrese, MBA, RPh, CPEL, FASHP, Executive Vice President and CEO of ASHP. "The PROTECT 340B Act of 2026 prohibits PBM and insurer discrimination against safety net hospitals and clinics, and creates an independent 3rd party clearing house to oversee the program."

BACKGROUND

The 340B Drug Pricing Program was enacted by Congress in 1992 with bipartisan support and is overseen by the Health Resources and Services Administration (HRSA) under the Department of Health and Human Services (HHS). The program requires that pharmaceutical companies give safety net and rural healthcare providers discounts on their drugs, in exchange for having their drugs covered by Medicaid.

The program has a demonstrated record of protecting patients who are low-income, live in underserved communities, or suffer from serious chronic illnesses from the threat of skyrocketing prices for the drugs they depend on the most.

For safety-net providers already operating on tight margins, reduction in 340B savings means fewer resources to provide the care Americans depend on. Shifting away from upfront discounts and adding new financial and administrative burdens puts even more pressure on providers, with patients ultimately paying the price. According to a 2025 survey by 340B Health, 92% of responding hospitals said they would have to reduce free or discontinued medications if manufacturers broadly implemented proposed rebate models.

Congresswoman Matsui has long championed improving 340B to ensure its benefits reach the patients and communities Congress intended. In 2025, she introduced the 340B PATIENTS Act to protect access to medications through contract pharmacies and led a bipartisan letter signed by 166 members of Congress opposing the administration's rebate pilot. She also led a bipartisan effort this year to block federal funding for implementation of the rebate model, warning the shifting away from upfront discounts could place new financial burdens on safety-net providers and threaten patient care.

The PROTECT 340B Act is endorsed by the Association of American Medical Colleges (AAMC), America's Essential Hospitals, American Hospital Association, Children's Hospital Association, National Rural Health Association, American Society of Health-System Pharmacists, California Hospital Association, California Children's Hospital Association, Ascension, National Association of Community Health Centers (NACHC), and National Association of Counties (NACo).

Original cosponsors of the legislation includes Representatives Stephanie Bice (R-OK), Jim Costa (D-CA), Sharice Davids (D-KS), Maggie Goodlander (D-NH), Eleanor Holmes Norton (D-DC), Jonathan L. Jackson (D-IL), Raja Krishnamoorthi (D-IL), Stephen F. Lynch (D-MA), Seth Moulton (D-MA), Debbie Dingell (D-MI), Dan Meuser (R-PA), and Gwen Moore (D-WI).

Full text of the PROTECT 340B Act availableHERE.