$1.1 billion in projected 2027 savings would come from a proposed CMS rule cutting Medicare reimbursement for 340B hospitals, with the administration saying older patients could save about $800 a year in co-pays.
The proposal would cap payments at average sales price minus 33.4%, after a 2025 survey found hospitals could buy discounted drugs cheaply and still bill Medicare and patients far more.
Lupron Depot was cited as an example: a 340B hospital can buy a dose for about $700, receive roughly $4,000 from Medicare and collect another $1,000 in patient cost-sharing.
Hospital groups immediately pushed back, with the American Hospital Association warning lower 340B revenue could strain essential services for low-income communities.
The rule would take effect next year if finalized, reviving a policy Trump first pursued in 2018 after the Supreme Court blocked a separate 340B reimbursement plan in 2022.