DPC in RealClearHealth: CMS Is Reining in 340B Program Abuse – Rural Patients Will Benefit

The Domestic Policy Caucus penned an op-ed for RealClearHealth, “CMS Is Reining in 340B Program Abuse – Rural Patients Will Benefit,” which was published today.

In part, DPC wrote, “Ask most 340B hospital executives what the 340B program pays for, and you will get a warm answer about the safety net. Ask for the receipts, and the conversation tends to end. That is the whole problem, and the administration has a chance to fix part of it this month. The Centers for Medicare and Medicaid Services (CMS) has proposed a rule that would stop Medicare from paying hospitals far more for certain drugs than the hospitals pay to acquire them… CMS should finalize the rule as written. Then, Congress should finish the job by defining who counts as a 340B patient, reining in contract pharmacies, and making eligible hospitals report what they collect and where it goes.

Read the full op-ed here.

DPC Responds to CMS Request of Comments on Medicare Program, 340B Drug Pricing

The Domestic Policy Caucus today responded to a Request for Comments on A Proposed Rule by the Centers for Medicare & Medicaid Services, “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; etc.,” specifically providing comments on the 340B drug pricing program.

DPC wrote, in part, “Congress created the 340B Drug Pricing Program over three decades ago to help genuine safety-net providers improve access to quality care for low-income communities, and later expanded it to reach rural communities directly, extending eligibility to the critical access hospitals, rural referral centers, and sole community hospitals on which many rural areas depend. Unfortunately, that original purpose has been taken advantage of, driving unprecedented program growth in recent years. Rural communities have been particularly affected by this shift. The costs of an unchecked and expanding program are borne across Medicare, Medicaid, and drug prices generally, and they fall most heavily on rural families who already contend with fewer providers, longer travel to care, and less financial flexibility. Aligning Medicare’s payments with hospitals’ actual acquisition costs is a measured step toward restoring the program’s integrity and, as a budget-neutral policy, would drive increased payments to small, rural providers across the country where resources are needed most.”

Read the full DPC comments here.

DPC in Duluth (Minn.) News Tribune: Bank mergers that benefit consumers shouldn't be partisan

From the column: "If a proposed merger satisfies the law’s rigorous regulatory standards, it should be judged on whether it expands opportunity, strengthens competition, and benefits consumers..."

Read the full column here.

Coalition Urges Federal Regulators to Judge Bank License Applications on Qualifications, not Politics

The Domestic Policy Caucus has signed onto a coalition letter urging federal regulators to judge bank license applications solely on qualifications, not on ideological agendas.

In a letter to Kevin M. Warsh, chair of the Board of Governors of the Federal Reserve System, the coalition wrote, "Non-prime consumers need lending products and will find them from unlawful sources if lawful sources are restricted.  More banks in this space would expand supervision, not reduce it.  Every categorical denial pushes lending further from supervision. The borrower's need survives. Only the regulator's line of sight is lost."

Read the full coalition letter here.

DPC Applauds Call to Improve Bank Merger Review Process

The Domestic Policy Caucus applauds members of the House Financial Services Committee who are urging the Federal Reserve to continue improving the efficiency of its bank merger review process.

In a recent letter, the committee members recognize an important principle: Regulators can maintain rigorous oversight while ensuring that unnecessary delays do not prevent financial institutions from investing, innovating, and expanding opportunities for consumers and small businesses.

The letter correctly notes that banking mergers already undergo extensive scrutiny before formal applications are submitted. Regulators evaluate competition, financial strength, managerial resources, consumer protection, and Community Reinvestment Act performance through a transparent regulatory framework. By the time most applications reach the Federal Reserve, they have already survived significant due diligence, making timely regulatory decisions both practical and appropriate.

As the letter observes, delays impose real costs by creating uncertainty for employees, customers, and investors while slowing investments and integration efforts. The source of some delays includes the receipt of adverse comments on an application for merger, which only in recent years has unfortunately become a partisan exercise. Banking innovation used to draw bipartisan and enthusiastic support from both Democrats and Republicans; today, Democrats often oppose mergers within the financial services industry on dubious grounds.

The proposed combination of Enova International and Grasshopper Bank provides a case in point and illustrates why every transaction deserves an objective review based on its merits rather than ideological opposition to consolidation. The merger would combine an experienced online lender with a digital-first bank to create a nationwide institution focused on serving consumers and small businesses that have often been overlooked by traditional financial institutions. By operating as an FDIC-insured bank with a national charter, the combined company would replace a patchwork of state lending requirements with a more consistent federal regulatory framework while benefiting from the stability of insured deposits. Those efficiencies have the potential to expand responsible lending, improve access to modern banking products, and strengthen financial inclusion.

This is precisely the type of innovation regulators should evaluate through evidence, not preconceived partisan assumptions. Yet this proposed merger has drawn criticism from some Democrats, notably attorneys general from several states.

The Domestic Policy Caucus supports a regulatory framework that protects consumers while encouraging responsible innovation, competition, and expanded access to financial services.

Efficient, predictable merger reviews, free of partisanship, are an essential part of achieving those goals.

DPC to Congress: Patients Deserve Care—Not Insurance Red Tape

In light of hearings on the cost of healthcare being held by the U.S. House Energy & Commerce Health Subcommittee today, the Domestic Policy Caucus is calling on Congress to focus on red tape and bureaucracy that hinders patients from getting the healthcare they need.

Health insurance is supposed to provide peace of mind when illness strikes. Yet for far too many Americans, coverage comes with a maze of administrative obstacles that delay treatment, increase costs, and leave patients wondering whether they will receive the care their physicians recommend.

Most Americans believe insurer prior authorization requirements are a burden, and many say insurance red tape is the biggest challenge they face when they are sick and navigating the healthcare system. These hurdles often require physicians to obtain insurer approval before patients can receive medications, procedures, or other medically necessary services—even when those services are ultimately approved.

This system creates unnecessary delays for patients while diverting physicians and healthcare staff away from patient care and toward paperwork. If insurers routinely approve a particular treatment more than 90 percent of the time, policymakers should ask why that service remains subject to prior authorization in the first place. Streamlining or eliminating these requirements for consistently approved services would reduce waste, lower administrative costs, and help patients receive timely care.

Greater insurer accountability is essential. Health plans should be transparent about denial rates, approval timelines, and the clinical evidence supporting their coverage decisions. Patients deserve clear explanations when care is delayed or denied, and providers should not be forced to spend countless hours appealing decisions that ultimately prove medically appropriate.

Healthcare affordability is about more than premiums and deductibles. Administrative barriers imposed by insurers carry real costs—in delayed diagnoses, postponed treatments, higher provider overhead, and unnecessary frustration for patients and families.

A healthcare system that works for patients must hold every stakeholder accountable. That includes insurers. Reducing unnecessary administrative barriers, improving transparency, and ensuring timely access to medically necessary care are practical reforms that would strengthen the healthcare system while putting patients—not paperwork—at the center of healthcare.

That’s why the Domestic Policy Caucus is pleased to see the U.S. House Energy & Commerce Health Subcommittee turn its attention toward healthcare costs. We hope the focus lands where it belongs.

Read more in this insightful column by Sally Pipes of the Pacific Research Institute

DPC in The Detroit News: Small-dollar loans aren't predatory -- they're a lifeline

The Domestic Policy Caucus penned an op-ed, "Small-dollar loans aren't predatory -- they're a lifeline," for The Detroit News.

In part, DPC wrote, "The benefits of small-dollar loans from non-bank institutions are often overlooked by people who have no personal experience with them."

Read the full op-ed here.

DPC Applauds Court Ruling Against North Dakota Legislature’s Attempted 340B Abuse

The Domestic Policy Caucus applauds an April 27 ruling by U.S. District Court Judge Daniel M. Traynor that quashes the North Dakota Legislature’s attempt, through the recently passed House Bill 1473, to “facilitate and sanction the graft” associated with abuse of the 340B drug pricing program.

The 340B program, established in 1992, compels prescription drug manufacturers to provide deeply discounted drugs to certain clinics and hospitals, with the understanding that the clinics and hospitals will either pass along the saving to patients, or charge insurers the full price and then use the profits to provide additional charity care. Participating in the 340B program is required for manufacturers who want to participate in federal Medicaid and Medicare programs.

With no restrictions on how 340B funds are used and few reporting requirements, many hospital systems are abusing the program and using it to amass huge profits at the expense of patients, employers, unions, and taxpayers.

In a sharply worded summary judgment in favor of AbbVie Inc. and Pharmaceutical Research and Manufacturers of America (PhRMA), Judge Traynor agreed with pharmaceutical companies that while the law purports to “protect the underdogs,” it illegally interferes with the federal drug-pricing regime. 

Judge Traynor said, “The states defending these laws say those populations [poor, underinsured, vulnerable] are the ones hurt when pharmaceutical companies put certain restrictions on delivery under the 340B program… However, a program meant to help American poor is being abused to provide a windfall to hospital conglomerates and participating pharmacies… North Dakota’s law attempts to facilitate and sanction the graft by interfering with an area of federal law… Here is what is really going on: a coordinated collusion between the state’s covered entities and contract pharmacies to exploit Congress’ inattention to a federal program. As a result, pharmacies and third-party administrators pocket billions of dollars each year… Manufacturers should [not] be fleeced by enterprising states and hospital conglomerates that wield power in legislative lobbies… Ultimately, it’s the patients who suffer… The 340B drug pricing program was meant to help the needy who require medication to live. H.B. 1473 benefits hospital conglomerates and Joe Paycheck sees no difference in the price of his meds… H.B. 1473 is an infringement on federal programs masquerading as state governance.”

Read the full LAW360 article about the decision here.

The court ruling represents an excellent example of the checks and balances that our nation’s founders envisioned. In this case, a federal judge has quashed overreach by the rogue North Dakota legislature, to the benefit of American patients, employers, unions, and taxpayers.

The Domestic Policy Caucus applauds Judge Traynor’s judgment.

National Popular Vote Appears in the Washington Examiner

National Popular Vote senior consultant, Patrick Rosenstiel, recently penned an op-ed in the Washington Examiner imploring conservatives to embrace the National Popular Vote, while disproving some common misconceptions about the Compact.

In the article, Rosenstiel said, in part, “The conservative movement should embrace reform that makes every voter in every state politically relevant in every presidential election. I believe that our ideas are better, more aligned with most voters, and can win presidential elections. President Donald Trump bolstered this belief when he won the national popular vote in 2024.”

Read the full op-ed here.

DPC in Duluth (Minn.) News Tribune: Minnesota, Wisconsin consumers deserve more, not fewer, credit options

From the column: “Americans with modest means deserve the same range of financial tools as those who are better off… Any credit-restriction proposal that comes up in Minnesota or Wisconsin should be given no consideration.”

Read the full column here.