Oregon lawmakers have long stood for transparency, affordability and access in health care, especially for low-income and underserved communities. But recently passed Senate legislation in Salem threatens to undermine these values and further entrench a deeply flawed system.

Every year, thousands of Oregonians rely on nearly 40 independent infusion centers across the state for treatment of complex, chronic conditions, such as cancer and autoimmune diseases. These centers are lifelines, providing specialized, community-based care that improves health outcomes and allows patients to lead full, productive lives.

In rural areas, where care options are already limited, these centers are often the only option.

Yet, our ability to serve these patients is increasingly threatened by the 340B Drug Pricing Program, a federal initiative that has veered far from its original mission.

Established by Congress in 1992, the 340B program was designed to help hospitals and health centers serving low-income and underinsured populations by requiring drug manufacturers to offer steep discounts on outpatient medications. The goal was clear: Make essential medications more affordable for those who need them most.

However, because of vague federal guidelines and lack of oversight, the program has become a vehicle for profit rather than patient support. A study by IQVIA found that patients receive a discount on just 1.4% of prescriptions eligible under 340B – an alarming signal that benefits are not reaching those they were intended to help.

Now, an active bill in Oregon, HB 2385, would further entrench hospital systems’ ability to profit from 340B without passing savings onto patients. The bill will expand hospital control of the program while leaving independent providers – who do not benefit from 340B – at a dangerous disadvantage. Hospitals are able to purchase drugs at steep discounts and bill insurers or patients at full price.

Meanwhile, independent practices must operate within a fragile reimbursement structure, while striving to keep care affordable and accessible.

As the only rheumatology practice within hundreds of miles of the Eugene-Springfield area accepting TriWest veterans, Medicaid patients and the uninsured, my clinic is a critical access point for patients in desperate need of specialized care. We provide essential in-office infusions for complex autoimmune diseases, closely monitored by a board-certified rheumatologist and trained infusion nurses. These treatments cannot be safely or effectively administered in retail settings or remote hospital systems. They must be local, timely and carefully managed.

However, because independent practices like mine are excluded from 340B pricing, we face steep medication costs and limited reimbursement – threatening our ability to continue offering these life-sustaining treatments.

This is not just about fairness for providers. It’s about equity for patients. And it’s about preserving access to care for Oregonians in communities such as Redmond, Bandon, La Grande and across the state – communities where independent infusion centers are the only realistic option.

At a time when so many independent providers are already struggling, especially in rural Oregon, this is not the moment to double down on a broken system. Oregonians deserve reforms that prioritize patients, not policies that inflate hospital profits at their expense.

HB 2385 does not deliver on the promise of affordable, accessible care. Instead, it expands the abuse of a federal program that has grown out of control.

Oregon’s elected leaders have the opportunity – and responsibility – to oppose this bill and refocus on policies that truly serve the best interests of patients and the providers who care for them.

Dr. William P. Maier is founder and director of William P Maier MD PC, an independent, nonaffiliated Rheumatology Specialist Clinic and multi-specialty IV center in Eugene, serving all counties in Oregon and all patients, including Medicare, Medicaid, veterans and the uninsured.