By Ted Slafsky
Last year, I wrote a column about the irresponsible tactics of a Washington D.C.-based dark money group that poured millions of dollars into derailing state efforts to restore access to 340B discounts in the contract pharmacy setting. The group, which calls itself Building America’s Future (BAF) and does not disclose its funders, ran a highly misleading and, one could argue, racist campaign. It warned state Republican lawmakers that by supporting the 340B program, the legislators would be contributing to illegal immigration and lawlessness in the United States.
As state legislators took up bills last winter to protect pharmacy relationships between 340B providers and retail pharmacies, BAF began targeting state lawmakers and such efforts in conservative states. Featuring images of nefarious activity by immigrants lacking permanent legal status, the ad ominously warned: “The border is broken. Millions illegally pouring into our country. But it’s not just the border: Your tax dollars are at work for illegal immigrants. The more we look, the more we find…And free healthcare? They’re using a program currently under investigation called 340B to launder your money and provide free healthcare for illegal immigrants. The more we look, the more we find. We need Republicans to stand up for us.”
Coordinated Campaign
At the same time, conservative news outlets published articles and posted comments on social media raising similar concerns about the 340B program. Soon, the dark money group started pouring money into state House and Senate races against lawmakers who endorsed or supported these bills.
While it would be tempting to ignore these efforts, the truth is they had an impact. First of all, the group has ties to a highly influential operative close to President Donald Trump, who served as spokesperson for Robert F. Kennedy Jr. during his Health and Human Services secretary confirmation bid and has been selected to join the new Department of Government Efficiency (DOGE).
One of the dark money group’s first successes came in my home state of Virginia, where Gov. Glenn Youngkin (R) quickly caved into the campaign.
A bill to restore access to 340B pricing for community health centers passed the Virginia Senate by 40-0 margin and the Virginia House of Delegates by a 92-5 vote. Days after the bills passed, the dark money campaign went into action. Shortly thereafter, Youngkin blocked the bill.
When Youngkin’s spokesperson was asked about the legislation, he said the governor “is deeply concerned about the federal 340B program and how it could be exploited to provide taxpayer subsidized healthcare to illegal immigrants.”
Ridiculous Accusations
Give me break. How many immigrants are leaving their countries for 340B-discounted drugs? Except for a small percentage of us who work in the 340B field, how many U.S. citizens even know about this important program that serves as a lifeline for safety-net providers and their patients?
In Kansas, the Republican-controlled legislature easily passed a contract pharmacy bill last April, only to reverse course a few weeks later. It is unclear how much of an impact the dark money campaign had on its reversal, but it certainly had some effect. Fortunately, Kansas Gov. Laura Kelly (D) vetoed the legislature’s last-minute effort to indefinitely postpone those 340B protections from taking effect.
In Missouri, some key GOP lawmakers and candidates started to echo the messaging of the dark money group, including tying 340B not only to illegal immigration but to “funding abortions.” Fortunately, some of these key lawmakers ending up losing their races, while others eked out victories.
Latest Smear Tactics Reach the Highest Levels
If you thought that perhaps BAF would have better things to focus on this year, you would be wrong. Sixteen states, including several deep red states, have already introduced similar 340B protection bills in the 2025 legislative session.
In response, BAF has started a new campaign that includes the placement of provocative billboards in front of state capitols stating that: “340B Is Subsidizing Gender Transitions for Kids.” The group has also placed articles in conservative media outlets, gotten the attention of conservative influencers and has even riled up Donald Trump Jr.
It is important to set the record straight:
Initiative Backfiring?
Fortunately, the dark money groups have not yet been successful, and it appears their tactics are backfiring. On the same day that BAF placed a billboard in front of the Kentucky state capitol in Frankfort, a state Senate committee voted 9-1 to approve a contract pharmacy bill, which was then approved by the full Senate. On February 12, Nebraska state senators voted 7-1 to advance a similar bill in its unicameral legislature after BAF ran a similar billboard in Lincoln days earlier.
It appears that lawmakers are catching up to these lowball antics. Maybe that is because this commonsense legislation benefits hospitals and other providers primarily located in rural and other underserved areas. And, of course, their patients that depend on these providers and affordable health care.
Kudos to the advocates and state legislators who are not putting up with these antics. Hopefully, the momentum to pass these laws will continue and 340B providers can go back to the work of taking care of our most vulnerable patient populations.
Ted Slafsky is the Publisher and CEO of 340B Report, the only news and intelligence service exclusively covering the 340B program. Slafsky, who has over 25 years of leadership experience with the 340B program, is also Founder and Principal of Wexford Solutions.
Ted can be reached at ted.slafsky@340Breport.com.
Disclaimer: The views and opinions expressed in this blog are those of the authors. They do not necessarily reflect the official policy or position of any other agency, organization, employer, or company.
