How Drug Companies Are Undermining Florida’s Health Care Safety Net: Insights from John Arcano

Taxpayers, brace yourselves—another round of bailouts may be on the horizon.

This time, it’s not Wall Street needing a rescue; it’s rural health care providers struggling just to stay afloat. Unlike big banks that gambled and lost, these nonprofits are doing their best to provide care without taking unnecessary risks.

Right now, Florida’s lawmakers have a chance to help. They can ensure that local health providers benefit from the 340B Drug Pricing Program. This program allows these facilities to purchase medications at reduced prices, crucial for keeping their doors open and serving communities in need.

But drug companies have a different plan. They want to change how these savings work, shifting from upfront discounts to delayed rebates. This means health providers might have to wait a long time, if they get anything at all. For many rural providers operating on tight budgets, this could spell disaster.

A recent report from the Center for Healthcare Quality and Payment Reform revealed that 760 rural hospitals are at risk of closing, with 40% facing immediate danger. In Florida, nine rural hospitals are at risk, highlighting the urgency of the situation.

In August, the Trump administration introduced a pilot program for this rebate model, but many are concerned it will not benefit the providers who need help the most. This new approach limits savings to only a few selected drugs, leaving many providers vulnerable if they rely on other medications for their services.

Florida’s state assembly can act now to protect these vital resources. They could introduce legislation that shields providers from these new rebate models, ensuring they continue to receive crucial savings. It’s important that Florida doesn’t wait for federal measures that may take a long time to address these needs.

Governor Ron DeSantis recently pushed for pharmacy benefit reform. While that was a significant step, lawmakers still need to safeguard 340B providers from drug companies looking to limit discounted prescriptions. In 2025, a proposed bill meant to protect these rural providers faced challenges and ultimately failed.

The reality is clear: federal solutions take time and may not arrive at all. Florida can lead the way by taking decisive action to protect its rural health care system from these corporate shifts.

Drug companies are trying to dismantle the 340B program piece by piece. State lawmakers have the power to intervene and protect essential services. Now is the time to act before it’s too late.

John Arcano is the senior manager of policy and government affairs at AIDS Healthcare Foundation.

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