ICYMI: The 340B Drug Pricing Program is a lifeline for patients like ours
April 10, 2026
ICYMI: Rachelle Schultz, CEO of Winona Health called the 340B Drug Pricing Program a survival issue for communities and patients like those in Winona.
Like many hospitals in rural Minnesota, Winona Health relies on 340B to fund essential services in a community that would otherwise not be able to afford to keep them afloat. For Winona Health, this includes cancer care, pharmacy access, chronic disease management, and services for patients who are uninsured or underinsured.
From Schultz’s Op Ed in the Rochester Post Bulletin:
I want to be direct: We could not afford the medications our patients need without 340B. And if we cannot afford them, our patients do not get them. It is that simple.
This is not a program that pads hospital budgets. It is a program that keeps the doors open.
A math issue: Schultz explained that more than half of Minnesota hospital patients are covered by Medicare or Medicaid, programs that typically reimburse less than 68 cents for every dollar it costs to provide care. That, combined with rising pharmacy costs, results in hospitals that would not be able to make the math work to keep services in place without the discounts they receive on drugs from 340B.
340B is under attack from Big Pharma and Minnesota has the chance to protect it. A bill in the Minnesota legislature that would permanently protect the program and give the attorney general authority to enforce the law and hold pharmaceutical companies accountable.
The 340B Drug Pricing Program Is a Lifeline for Patients Like Ours
By Rachelle Schultz, EdD, President and CEO, Winona Health
Winona Health is a 49-bed hospital in southeastern Minnesota. We are the definition of a community hospital in greater Minnesota — too big to be small, too small to be big. We do not have the economies of scale of a large health system, and we do not have the special protections reserved for critical access hospitals. What we do have is a community that depends on us for everything from cancer treatment to maternity care to behavioral health services.
The federal 340B Drug Pricing Program helps hospitals like ours purchase certain outpatient medications at a discount so we can invest those savings directly into patient care. It is one of the few tools we have left to stretch our resources and keep essential services running in a community that cannot afford to lose them. Nonprofit hospitals like ours don’t answer to shareholders — we answer to patients, families, and communities — and every dollar from programs like 340B is reinvested directly into their care.
I want to be direct: we could not afford the medications our patients need without 340B. And if we cannot afford them, our patients do not get them. It is that simple.
This is not a program that pads hospital budgets. It is a program that keeps the doors open. At Winona Health, 340B savings support cancer care, pharmacy access, chronic disease management, and services for patients who are uninsured or underinsured. Without it, those services shrink or disappear — not because the need goes away, but because the math no longer works.
The math is already challenging. More than half of Minnesota hospital patients are covered by Medicare or Medicaid, programs that typically reimburse less than 68 cents for every dollar it costs to provide care. Pharmacy costs have soared 31% between 2022 and 2026. Two-thirds of Minnesota hospitals operated at a financial loss in 2023. Nearly a third are financially distressed today. The 340B program helps offset a portion of the $2.4 billion in uncompensated care that Minnesota hospitals provide every year.
Yet right now, more than 20 multinational for-profit pharmaceutical manufacturers are restricting or blocking hospitals from accessing 340B discounts through their contract pharmacies. Rural hospitals across the state are already losing scarce resources each year because of these restrictions. For hospitals our size, that is the difference between keeping a service line open and closing it.
These are not small companies struggling to make ends meet. The top 10 pharmaceutical manufacturers alone reported over $100 billion in profits in 2024. They agreed to provide 340B discounts as a condition of participating in Medicare and Medicaid. Now they want to walk that commitment back — and Minnesota patients are paying the price.
Minnesota took an important step in 2023 by passing a law prohibiting manufacturers from interfering with 340B contract pharmacy arrangements. In February 2026, the Minnesota Court of Appeals upheld that law. But the protections are set to expire on July 1, 2027, and pharmaceutical companies are in court trying to run out the clock. Legislation now before the Legislature would make these protections permanent and give the Attorney General enforcement authority. It deserves strong bipartisan support.
340B may begin with discounted drugs, but where it ends is access to care. It ends with a cancer patient in Winona getting treatment close to home. It ends with a young mother filling a prescription she could not otherwise afford. It ends with a hospital that can keep its doors open in a community that has nowhere else to turn.
The 340B program requires no taxpayer dollars. Every dollar of savings comes from pharmaceutical company profits, not public budgets. Congress designed it that way in 1992 because lawmakers understood that safety-net hospitals needed help stretching scarce resources to serve vulnerable patients. That need has only grown.
This is not a partisan issue. It is a math issue. And for the patients and communities we serve, it is a survival issue. I urge legislators to make Minnesota’s 340B protections permanent — because for hospitals like Winona Health, this program is a lifeline. And where it ends is whether care is there when our patients need it, or not.