Community health centers are calling on state and federal lawmakers for added protections against drug manufactures for drastically cutting them out of a federal drug discount program.

The 340B Drug Pricing program allows health centers to purchase outpatient medication at reduced costs, so they can then provide it to a greater reach of patients while drug companies get reimbursed. But in the past two years, drug producers and third-party prescription drug benefit managers have been restricting centers, threatening their financial stability.

A survey by the National Association of Community Health Centers shows more than half their patients would go without needed medications, including insulin for diabetes patients and inhalers for children with asthma, if they are cut out of the program.

Ben Browning, vice president and CEO of the Florida Association of Community Health Centers, explained the importance of the program.

"These contract arrangements are really the lifeblood," Browning contended. "They are the lifeline for a lot of the patients that may not otherwise have access to these reduced-cost, reduced-price medications."

But the Pharmaceutical Research and Manufacturers of America, the lobbying arm of the drug-manufacturing industry, countered the program needs to change, claiming there is little to no evidence patients are benefiting. They also are calling for centers to share data in an effort to tamp down on potential fraud and abuse in the system.

Browning argued the centers continue to fill a critical need because many health care providers do not have the financial resources to support an in-house pharmacy. The survey showed 86% of health centers utilize contract pharmacies, allowing them to serve hundreds of ZIP codes.

"Put some protections in law, in regulations, in statute, that said the 340B program is a vital component of the health care system," Browning urged. "This is a vital component of maintaining and securing the safety net."

It is estimated enrolled hospitals and other covered entities in 340B can achieve average savings of 25% to 50% in pharmaceutical purchases. The issue is also playing out in courts with conflicting rulings across the country.

Arkansas is set to reduce income tax rates for individuals and corporations starting next year.

Opportunity Arkansas is advocating for the elimination of the state income tax altogether.

Nicholas Horton, founder and CEO of the group, said the new top tax rate of 4.4% still penalizes people for earning more money. Horton believes eliminating the state income tax would help Arkansans keep more of their income.

"Reality is, we've been chipping away at the state income tax pretty aggressively," Horton acknowledged. "And we talked about this in the report. What's been happening is, revenue has actually gone up, because people have more money in their pockets to spend at local small businesses, all across the Arkansas economy."

Medicaid is the largest single line item in the state budget, consuming more than one in every four dollars the state spends. Horton said Medicaid spending is key to addressing Arkansas' budget gap. He added the state's income tax generates only about $3 billion a year, while the state spends close to $35 billion.

Horton pointed out in recent years, Arkansas has lowered its income tax rate from nearly 7% to 4.4%. He explained a report from his organization outlines strategies state policymakers can implement to accelerate the state income tax elimination.

"We worked a lot with state policymakers in the Legislature and the executive branch," Horton recounted. "Our objective was to really present a menu of options, and start a more detailed conversation about how we get to zero."

Horton added Texas and Tennessee have eliminated the personal state income tax, and thinks following suit would be "transformative" for Arkansans.


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Alabama Arise, a statewide advocacy group, is fighting for marginalized communities affected by poverty.

The organization recently unveiled its 2024 policy priorities, highlighting the importance of expanding Medicaid and ending the state sales tax on groceries to improve residents' overall well-being.

Robyn Hyden, executive director of the group, believes addressing the issues will create lasting effects on communities and improve communication with legislators.

"Some people feel a sense of powerlessness, a feeling that our political systems are not set up to listen to us or respond to our needs, the needs of everyday folks," Hyden explained. "We really work hard to refute that by showing that regular everyday citizens do have power in raising their voices together. "

She noted Arise's policy goals also include increasing human service budgets, securing education funds, preserving voting rights through no-excuse early voting and easier rights restoration. The organization also aims to tackle policies aimed at improving criminal justice outcomes, maternal and infant care and public transportation funding, and requiring unanimous jury decisions in death-penalty cases.

Hyden pointed out change does not happen quickly and takes everyone working together. She emphasized some ways they plan to work to bring the policies to life are through policy analysis, producing advocacy materials such as fact sheets and reports to spread information, and empowering regular citizens to engage with local lawmakers in their districts.

"We always want to go into the legislative session having fully educated lawmakers about how important it is to address poverty in their district and how we think they could do that," Hyden stressed. "We never want to hear a lawmaker stand up and say, 'Hey, nobody in my district has talked to me about this.'"

Alabama Arise achieved partial success this year when the state sales tax on groceries was unanimously reduced by half. However, she admitted more can be done and said they will continue to fight for the complete removal of this tax burden on low-income families. She added they will be challenging state income tax deductions currently benefiting the wealthiest households.

A group of veterans is touting the national security benefits of the Inflation Reduction Act.

The organization Elected Officials to Protect America said the law, passed by Congress in 2022, will decrease the country's dependence on foreign sources of energy with a $370 billion investment in clean energy.

Beaverton Mayor Lacey Beaty, an Army veteran, said in the wake of the region's devastating wildfires and the heat dome, she helped push for protections for renters in Oregon.

"While I'm very proud of that legislation, I'm very proud that the governor signed it and I was very proud to build the coalition to do it, imagine what a tenacious mayor could have done if I wasn't focusing on climate-related emergencies," Beaty pointed out. "We could have been building more pipes in schools and infrastructure and bridges."

Beaty stressed the recent disasters in the state have underscored the importance of taking action on climate change.

Alex Cornell du Houx, president and co-founder of Elected Officials to Protect America, a former marine and Maine state representative, pointed to the conflict in Ukraine as evidence of the importance of energy independence.

"With the Inflation Reduction Act, it is part of the solution to decouple ourselves from this dependency on the source of energy in which autocratic nations primarily control," du Houx explained. "That's the exciting thing about it. It's an amazing solution that's really tangible and a historic investment."

Beaty contends mayors like her will ensure funds from the Inflation Reduction Act go to the places doing the most good to fight climate change.

"We can be trusted by the president to deliver on the ground," Beaty emphasized. "That's why we see so many mayors excited about the Inflation Reduction Act, because we know how to put money to work right away."


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