Opinion: 340B drug discounts supports patients, not profits

AJ Wilhelmi, President and CEO, Illinois Health and Hospital Association
Crain's Chicago Business
May 4, 2026

The April 29 oped, “Hospitals stash billions overseas — and want Illinois to expand their drug discounts,” mischaracterizes both the purpose of the 340B Drug Pricing Program and the realities facing Illinois hospitals.

Contrary to the author’s assertion, the 340B program is not a “profit center” — it is a lifeline for patients and communities. It allows hospitals that care for large numbers of Medicaid and uninsured patients to purchase outpatient drugs at a discount and reinvest those savings directly into patient care. Across Illinois, these funds support free and reduced-cost prescriptions, behavioral health services, cancer care, maternity services, and rural and urban clinics that would otherwise close their doors.

Pharmaceutical manufacturers — many located overseas, earning tens of billions of dollars in annual profits — are actively working to restrict hospital access to 340B discounts. Limiting these resources does not lower drug prices; it reduces the ability of providers to deliver care to those who need it most.

Claims about hospitals “stashing billions overseas” are misleading. Large health systems often maintain diversified financial assets — including internationally managed funds — to support long-term stability, self-funding of medical liability risks, pensions, capital investments and bond obligations. These are not idle profits diverted from patients; they are part of prudent financial stewardship that ensures hospitals can continue serving their communities, especially during economic downturns or public health crises. Nonprofit hospitals use their revenue to improve patient care and access, unlike drugmakers’ profits, which are dedicated to stock buybacks and shareholder returns.

Hospitals are not a drain on communities — they are anchors of care and economic stability. Illinois hospitals deliver more than $8.6 billion annually in community benefits, including charity care, education and research. They are also major economic engines, generating $135.5 billion annually and supporting more than 521,000 jobs statewide. Every dollar spent by hospitals returns $1.40 to local economies, supporting jobs and strengthening communities across Illinois.

The suggestion that 340B hospitals drive higher costs ignores the reality of healthcare pricing. Illinois hospitals are operating in an increasingly challenging environment. Expenses continue to rise due to unchecked pharmaceutical price increases, rising labor costs and supply chain pressures.

Uncompensated care is rising, reaching $659 million in 2024. Federal policy changes threaten coverage for up to 300,000 vulnerable Illinoisans, which would significantly increase the number of uninsured patients.

Layered on top of these pressures is Illinois’ challenging medical liability environment, where providers already face heightened exposure to malpractice risk and rising insurance costs. 

Policies that undermine hospital stability or limit resources available for patient care only exacerbate these risks and further strain access to care. The 340B program helps hospitals offset these costs and keep care accessible, particularly for vulnerable populations.

Importantly, despite what the author suggests, Illinois hospitals are not seeking to “expand” 340B. House Bill 2371 simply preserves the status quo by preventing pharmaceutical manufacturers from restricting access to federally authorized discounts. Similar legislation has been enacted in more than 20 states, and those laws are being upheld in court.

Hospitals already operate under strict federal and state oversight, and contrary to claims of limited transparency, the proposed legislation enhances accountability by expanding hospital reporting on how 340B savings are used to benefit patients.

HB 2371 costs the state nothing and ensures hospitals can continue using 340B savings to support patients and communities. Weakening this program would not help patients — it would reduce access to care and strain an already fragile healthcare system.