Why It Matters
Drug purchases through the 340B program reached $100 billion in 2025, and the explosive growth is triggering a Capitol Hill clash over how to regulate the discount system. A bipartisan group of senators introduced the SUSTAIN 340B Act to kill a contested rebate pilot, while House members pushed competing legislation to freeze rebates for four years.
The Big Picture
The pilot's timeline is accelerating: manufacturer plans are expected to receive approvals September 24, and a launch date is set for January 1, 2027.
Reps. Reps. John Joyce (R-PA-13) and Scott Peters (D-CA-50) introduced the SECURE 340B Act on July 6, offering an alternative framework that would impose a four-year moratorium on rebates and establish an independent clearinghouse to validate claims and prevent duplicate discounts.
The House bill targets a specific problem: since 2020, 41 manufacturers have imposed restrictions on how covered entities access 340B discounts. Over 25 major drug companies have imposed contract pharmacy restrictions since 2020. Nearly 60% of all U.S. pharmacy locations function as contract pharmacies under 340B.
Community health centers and federally qualified health centers serve over 31.5 million patients.
The Bottom Line
The SECURE 340B Act has not yet advanced to a vote, but it represents the House's effort to insert a pause into the rebate timeline while a clearinghouse system is built. The legislative activity reflects the stakes: 307 bills have been introduced on drug discount programs overall, with one passed and one hearing on record. The pharmaceutical industry is not sitting idle. PhRMA is running seven-figure ad campaigns for a rebate-based model.
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