340B State Legislation: Ohio
Overview
Ohio lawmakers are considering H.B. 276 and S.B. 198, proposals that would broaden the reach of the 340B program and could increase the financial strain on employers and working families.
The 340B program allows participating hospitals to purchase prescription drugs at steep discounts and then bill health plans at prevailing rates. Hospitals can retain the difference, but the program has limited transparency and few clear requirements to ensure those dollars directly support vulnerable patients in local communities. In practice, this structure can create misaligned incentives — rewarding higher markups, encouraging consolidation, and steering prescribing toward higher-priced medications rather than lower-cost biosimilars.
As hospitals route more drug volume through 340B, manufacturer rebates that would otherwise help offset plan costs and reduce premiums can be displaced. These lost rebates, combined with the “buy low, sell high” dynamic inherent to the program increase costs for employers and working families and the system as a whole.
Today, 340B is estimated to cost Ohio employers $275 million annually, and analyses indicate these proposals could add roughly $9 per beneficiary — about $51 million more each year for Ohio employers.
The National Alliance urges policymakers to prioritize reforms that strengthen oversight, transparency, and accountability before advancing measures that would further accelerate 340B growth.
340B Employer Resources
Explore the resources below to learn more about how 340B, and the legislation under consideration, could affect Ohio employers, unions, and working families.
