1. United States
2. Mich.
3. Letter

I am writing in strong support of the 340B Drug Pricing Program, and I want to be direct: this program needs to not only survive but grow. For rural Michigan and communities like it across the country, 340B is not some line item in a federal budget. It is what keeps community health centers, critical access hospitals, and small rural clinics running. Without it, many of them simply could not serve the patients who have nowhere else to go. Michigan's rural health system is in serious trouble. Another hospital has just closed. That means another community waking up without local emergency care, without prenatal services, without anywhere nearby to manage a chronic condition or see a doctor for something that should be simple. These closures are not accidents. They are what happens when you cut Medicaid and Medicare year after year, squeeze reimbursement rates, and leave providers with no cushion to absorb the losses. The 340B program has been one of the only things helping these hospitals and clinics hold on, giving them a way to stretch limited dollars and keep caring for patients who cannot afford to go without. I want to be honest about where things stand. The cuts to Medicaid and Medicare that have been made and proposed are not being made up for by anything else. The supports being offered are not enough. The gaps are real and they are getting wider. Rural hospitals run on margins so thin that even small reimbursement changes can tip them into closure. When that happens, it is not an abstract policy outcome. It is people driving an hour for care they used to get down the road. It is emergencies that become tragedies because help is too far away. I am asking policymakers to stop weakening the 340B program through manufacturer restrictions, narrow interpretations, and legislative rollbacks, and to start thinking about how to expand it. The safety-net providers who rely on 340B are doing essential work in communities that have been underserved for decades. They deserve protection and investment, not more uncertainty. Rural Michigan has already lost a great deal. The people here deserve a health system that is actually fighting for them. Protecting and expanding the 340B program is one of the clearest ways to do that.