While large hospitals and pharmaceutical manufacturers battle over drug costs, Missouri community health centers see themselves as collateral damage.

Section 340B of the 1992 Public Health Service Act, allows small community health centers and hospitals to buy pharmaceuticals at highly discounted prices.

Colleen Meiman, national policy adviser for the State Association of Community Health Centers, said the centers use the savings to support other community support services like dental, behavioral health or opioid treatment programs, all without taxpayer dollars.

"We don't have any negotiating power. We're stuck having to pay full price because we've got this tiny little nonprofit community entity up against a giant drug company," Meiman pointed out. "The law was meant to equalize that a little bit and then enable us to get the drugs at a discount."

Drug manufacturers are concerned about the misuse and fast expansion of the 340B program. Hospital and pharmacy drug provider sites increased from 8,100 to 50,000 between 2000 and 2020. An August 2022 report by the Health Resources and Services Administration found discount drug purchases through 340B increased 16% between 2021 and 2022 to $44 billion.

Meiman noted 340B can be helpful in Missouri where she lives, but added current restrictions limit the number of contract pharmacies in a given area of the state, which can create hardships for patients.

"In Missouri it can be hard to get around in the wintertime," Meiman explained. "If suddenly you have to drive a really long distance to get your medications, either because that's the only way you can get them discounted enough to afford them, because you're low income uninsured, or because you were trying to support your health center."

Meiman added health centers across the country have been forced to reduce staff or curtail services because they have lost access to 340B savings.


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Gov. Greg Abbott has until June 22 to sign or veto Senate Bill 3, which would ban consumable THC products in Texas.

Banning items like vapes and gummies were a priority for Lt. Gov. Dan Patrick during the legislative session. He said he would call a special session if a bill was not drafted. Patrick argued retailers are selling products with unsafe levels of THC to minors.

Morgan Deany's family owns a hemp farm in east Texas. She said her family switched from growing commercial chickens to hemp to provide a product that could help people suffering from different ailments.

"We wanted to make something to give back to animals and to people that was a healthy alternative versus the usual pharmaceutical products," Deany explained. "Hemp is so good for CBD."

Lawmakers authorized the sale of consumable hemp in 2019. Since then, thousands of cannabis dispensaries have opened across the state. The industry generates around $8 billion a year and has created approximately 50,000 jobs.

The bill has received pushback from both sides of the political aisle. Many THC users, including veterans, testified they use the products to ease chronic pain and anxiety. Patrick contended consumers, especially children, are buying products with dangerous amounts of THC but Deany countered it is not what they experienced.

"It came with some controversy," Deany acknowledged. "We had planes and helicopters flying over our property thinking that we were growing marijuana. Then we had to send off samples of our plants, pretty frequently, to make sure that it stayed underneath a certain level of THC."

If the governor doesn't sign or veto the measure, it will automatically become law.


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CORRECTION: The name of the California law is the 'End of Life Option Act.' A previous version of the story used the word 'Options,' not 'Option.' (11:20 a.m. PDT, June 16, 2025)

California's law legalizing medical aid in dying could be made permanent if lawmakers approve a bill currently before the State Assembly.

Senate Bill 403 would eliminate the sunset clause in the 2015 End of Life Option Act.

The law allows mentally capable, terminally ill patients with less than six months to live to get a prescription to end their life.

Advocate Dan Diaz says his wife, Brittany Maynard, moved to Oregon in 2014 to make use of that state's Death With Dignity Act.

"Brittany is gone, so now I'm fighting for all terminally ill individuals that might find themselves in Brittany's predicament," said Diaz, "so that they don't have to do what she did, of leaving their home state after being told you have six months to live."

The End of Life Option Act is currently set to expire in five years. Medical aid in dying is legal in 11 states plus Washington D.C. -- but California is the only jurisdiction with a sunset provision.

Leslie Chinchilla, California state manager with Compassion & Choices Action Network, said over the past decade, there hasn't been a single substantiated case of abuse involving medical aid in dying statewide.

"The California Department of Health does a yearly report on medical aid in dying," said Chinchilla. "There has been no instance of coercion or abuse, and really the law is working as intended."

In 2023, more than 1,200 terminally ill Californians obtained prescriptions for medical aid in dying and 69% took the medication.

Patients with end-stage renal disease have two treatment options: dialysis or a kidney transplant but because donor kidneys are scarce and wait times are long, most will need to start dialysis while they remain on the transplant list.

Research from Arizona State University aims to better understand the differences in the decision-making process among clinicians about whether to accept or reject a donor kidney.

Ellen Green, associate professor of health solutions at Arizona State University, the study's principal investigator, said candidates are matched with an organ donor through the nonprofit United Network for Organ Sharing and once matches are made, they are sent out to clinics where patients with end-stage renal disease are on waiting lists.

Green and her co-investigators want to determine if an individual clinician's willingness plays a role in accepting or rejecting a kidney donation.

"In this initial study, we don't know whether or not this is a good thing or a bad thing," Green observed. "It could be that the variability is demonstrating that some clinicians are pushing the envelope while other clinicians are learning and have resources to deal with certain types of transplants that maybe are higher risk."

There are about 90,000 people in the U.S. that are waiting for a kidney transplant, and 11 people die every day in that wait, according to UNOS. Studies show while many kidney donations are deemed viable, almost 30% are declined for transplantation despite strong demand. In Arizona, 730 kidney transplants were completed in 2024, according to the Organ Procurement and Transplantation Network.

As an economist, Green noted it is a challenge to understand how a system which is not driven by price operates. She acknowledged while their study looks to learn more about clinicians' willingness, she understands other variables can affect the decision-making process.

She hopes her work will help increase the availability of donated kidneys.

"What we want to better understand is, from a clinician-to-clinician perspective, is there something that we can do or better understand about this decision-making process that we can leverage to increase those chances," Green emphasized.

Green pointed out understanding individual decision-making is something flying under the radar and argued it needs to be incorporated into current models, otherwise opportunities to have successful kidney transplants could be negatively affected.