As Illinois lawmakers debate legislation involving the federal 340B Drug Pricing Program, much of the public discussion has focused on costs, reimbursements and financial estimates. Those questions matter. But they are only part of the story.

The larger issue is what happens to communities when hospitals face growing difficulty sustaining essential healthcare services.

Across Chicago and the country, healthcare providers are confronting rising costs, workforce shortages and increasing pressure on services communities rely on most — from trauma and neonatal intensive care to behavioral health and cancer treatment.

At a moment like this, weakening 340B would move healthcare in the wrong direction.

Congress created the 340B program in 1992 to help hospitals and clinics stretch limited resources and expand care for patients who are uninsured, underinsured or covered by Medicaid. The program allows eligible providers to purchase outpatient medications at discounted prices and reinvest those savings into patient care and community services.

Contrary to how critics often portray the program, 340B is not a financial windfall for hospitals. It helps healthcare providers redirect resources that otherwise would be spent on expensive medications toward services and programs communities depend on every day. According to Health Resources and Services Administration data, 340B discounts represent a relatively small share of pharmaceutical industry revenues.

At the University of Chicago Medicine, resources through programs like 340B help sustain our Level 1 trauma services, NICU, the South Side’s only burn center, and the city’s only hospital-based emergency helicopter transport, in addition to supporting patients’ access to medications they otherwise could not afford. Many of these services are financially challenging to sustain, yet they are indispensable to the health and safety of our communities.

Healthcare value also cannot be measured solely through charity-care percentages. Hospitals serving vulnerable communities are increasingly expected to invest not only in clinical care, but also in violence recovery, workforce development, food access and partnerships that address the broader conditions affecting health.

Our recently released Community Benefit Report documented more than $1.1 billion in community benefit investments in fiscal 2025, including uncompensated care, violence recovery services, workforce development and community partnerships across the South Side and south suburbs.

None of this means the 340B program should be beyond scrutiny. Transparency and accountability matter. Hospitals participating in the program should be able to demonstrate how savings support patient care and community benefit.

But policymakers also should recognize that programs like 340B have become part of the financial infrastructure that helps sustain healthcare access in underserved communities.

Americans are right to demand lower drug prices and greater accountability throughout the healthcare system. But weakening one of the few programs that helps hospitals and other providers extend care in vulnerable communities will not solve the affordability crisis.

It will simply make healthcare access more fragile for the patients and neighborhoods that already face the greatest barriers to care.

Mark E. Anderson is executive vice president for medical affairs at the University of Chicago. Thomas Jackiewicz is president of the University of Chicago Health System.