REFILL | Ryan Long on 340B Drug Pricing, Enhanced ACA Tax Credits, and Medicare Part D (Originally Aired: September 24, 2025)

Joe Grogan sits down with Ryan Long, healthcare policy expert and senior research fellow at Paragon, to discuss three critical healthcare policy issues facing Congress. First, the Congressional Budget Office's landmark analysis of the 340B drug pricing program, which revealed the program increases federal spending, drives up premiums, and channels most benefits to wealthy hospitals rather than those serving low-income patients. Second, the enhanced premium tax credits set to expire at the end of 2025, which have been plagued by fraud and fraudulent enrollment. Long explains how unscrupulous brokers have exploited the system, enrolling people without their knowledge, with billions in improper payments going to insurance companies. Third, the Inflation Reduction Act's devastating impact on Medicare Part D, including premium increases from thirty to sixty dollars monthly, coinsurance replacing copays, and seniors paying higher out-of-pocket costs despite the legislation's promise to lower drug costs.

Key Timestamps

1:20 Welcome to DC EKG and introduction of Ryan Long

2:15 Congressional Budget Office analysis of 340B program

4:06 Why CBO conducted the 340B study

4:25 How 340B increases federal spending and premiums

4:58 Studies showing 340B drives higher-cost drug utilization

5:30 Will CBO analysis lead to legislative reform efforts

6:15 Program expansion from 90 to 2,600 participating hospitals

8:06 Timeline for 340B reform legislation

10:43 340B program growth from two billion to sixty-six billion annually

11:52 Why insurance companies support limiting 340B