Last November, Kansans went to the polls in record numbers and helped elect President Trump to make America, and Kansas, great again. A key pillar of his campaign was a promise to “Make America Healthy Again,” with a focus on issues like transparency in health care and lowering costs for families.

But here in Kansas, there are some lawmakers flirting with a policy in direct opposition to President Trump’s efforts. They want to expand an opaque, anti-transparent, anti-free market policy called the 340B program. This program is good for big hospital system CEOs, woke politicians, and out-of-state pharmacies, but terrible for families, rural hospitals, and Kansans who care about good government.

The 340B program was created in 1992 with a simple goal: help struggling hospitals stretch scarce resources so they could provide increased care to low-income patients. Drugmakers were required to sell medicines at steep discounts, and hospitals could use those savings to serve the poorest among them.

But like so many government programs, 340B has strayed far from its original purpose. Today, the program is riddled with loopholes, ripe for abuse, and dominated by giant hospital systems that hardly resemble the safety-net providers Congress intended to help.

Instead of putting money back into patients’ pockets, hospitals often pocket the savings themselves. There’s no requirement for them to pass along discounted prices, and no transparency in how the funds are spent. In Kansas, families still pay sky-high drug costs at the pharmacy counter while hospitals build new wings, sponsor sporting events, and pad their budgets. It’s a recipe for corruption and bad governance.

Meanwhile, rural Kansas hospitals and independent pharmacies are getting squeezed. The more 340B expands, the more leverage the big systems have — while the little guys, the ones actually serving small towns and farm communities, are left behind. Expanding 340B without reform will only make a bad problem worse.

Then there are abortion providers. Some Planned Parenthood affiliates qualify for 340B and buy drugs at the same steep discounts. Every dollar Planned Parenthood saves on contraceptives or cancer screenings is a dollar freed up to fund their true operation — abortion. That’s a backdoor subsidy Kansans should not be forced to tolerate.

And let’s not forget the hidden cost-shifting. When manufacturers are forced to give deeper and deeper discounts under 340B, they don’t just eat the loss. They raise prices elsewhere, meaning families outside the program end up footing the bill. It’s no wonder prescription drug costs and insurance rates keep climbing.

You might wonder, “Where is all of this money going?” One consumer protection organization highlighted how nonprofit health systems across the country were “prioritizing political ideology over patients,” by leveraging federal funding streams, taxpayer dollars, and benefits from their tax exempt status to “advance woke agendas, including Diversity, Equity, and Inclusion (DEI), gender ideology, and climate activism, all over patient well-being.” What did all the hospitals they highlighted have in common? They subsidize their activities with the 340B program.

We have seen massive warnings about 340B abuse from other states as well. Louisiana Senator Bill Cassidy, chairman of the Senate Health, Education, Labor, and Pensions Committee that oversees large portions of our national health-care system, released a bombshell investigation highlighting how hospitals like Cleveland Clinic in Ohio had generated hundreds of millions in 340B revenue, but instead of passing off discounts to patients, they diverted those profits to other purposes that had nothing to do with their underserved patients. Former Ohio Secretary of State Ken Blackwell brought to light that the hospital system was using the windfall from 340B to fund programs like DEI, climate activism, and even “so-called gender affirming care,” including for minors.  

And that’s not the only case of 340B funds being tied to dangerous and experimental trans surgeries. An investigative report in Townhall highlighted how hospitals “tout online how they are able to ‘integrate hormone therapy within primary care,’ thanks to revenue generated from 340B savings.” The report also explains how 340B funds have been used to circumvent President Trump’s ban on taxpayer funding for sex change surgeries on minors.

The bottom line is this: 340B is broken. Expanding it now would only pour gasoline on the fire. Before anyone in Kansas even whispers about growing this program, they need to deliver real reform — transparency, accountability, and a return to the original mission of helping patients, not pushing woke political agendas and enriching corporate hospital CEOs. Kansans should not be forced to subsidize abortions, transgender surgeries, and DEI programs regardless of how its marketed.

Dan Hawkins of Wichita serves House District 100 and is Speaker of the Kansas House. This editorial was provided by the Kansas Informer.