340B Drug Pricing Program costing employee health plans $5B per year
“Hospitals realized they could buy heavily discounted drugs and resell them to insured, middle-class patients at huge markups.”
By Dan Crippen
An obscure, supposedly free federal program is blowing a hole in state budgets — by depriving state governments of billions in corporate tax revenue and inflating costs for their public employee health plans.
The culprit is the 340B Drug Pricing Program, which Congress established in 1992 to help safety-net hospitals. Once enrolled, qualifying hospitals and clinics and their partner pharmacies — collectively called “covered entities” — can purchase medicines directly from drug manufacturers or wholesalers at roughly 50% discounts.
Congress expected only about 90 hospitals to participate. Today, more than 2,600 hospitals are enrolled.
This explosive, unintended growth is the result of the program’s lax requirements. Covered entities are not required to expand charity care or even report how they use their 340B earnings.
Hospitals realized they could buy heavily discounted drugs and resell them to insured, middle-class patients at huge markups. In some cases, hospitals have charged cancer patients nearly ten times what they paid to acquire the drug.
The opportunity to upcharge patients has proven irresistible and fueled the program’s bloat. In 2023, covered entities purchased $124 billion worth of medicines — but only paid $66 billion, meaning they received roughly $58 billion in discounts.
Numerous audits have revealed that many hospitals use the funds to subsidize expansion in affluent neighborhoods, rather than support low-income or uninsured patients.
This perverse behavior harms state taxpayers. Because most 340B hospitals are technically non-profits, their earnings aren’t taxed. As a result, states collect about $3.5 billion less in corporate income tax and other tax revenue than they otherwise would. That’s money not available for public health, education, infrastructure, or employee benefits.
The 340B program hurts states in other ways, too.
The program incentivizes hospital systems to acquire independent clinics — which don’t qualify for 340B — and designate them as “child sites” that subsequently become eligible for 340B.
This leads to higher healthcare spending, since care at hospital-owned sites is more expensive than at clinics and independent practices.
Care at 340B hospitals tends to be more expensive than care at competing hospitals, too. The average per-patient prescription spending at 340B hospitals is 150% higher than non-340B hospitals.
All told, large employers and their workers spend over $5 billion more per year on health care as a result of 340B. Every extra dollar that businesses spend on health care is a dollar that’s deducted from their taxable income.
The program also inflates costs for state employee health plans. Utah recently found that its Public Employees Health Program is losing out on $3.9 million in rebate savings due to 340B.
Some state lawmakers are unwittingly compounding the damage by making it easier for pharmacies to contract with 340B hospitals and clinics.
Instead of boosting care for poor patients, 340B drains public resources while enriching large hospital systems. Reform is desperately needed.
Dan Crippen is the former Director of the Congressional Budget Office. This piece originally ran in RealClearHealth.
Work for the Post Office and earn up to $35.95/hour
OAKLAND, CA — The U.S. Postal Service is hosting a free hiring event to help future employees create their online profile and immediately start applying for jobs in Maintenance.
As part our innovative 10-year-plan, Delivering for America, the Postal Service is focused on building a more stable and empowered workforce. Our employees are our greatest asset, and we are investing in our new employees by providing robust training and on-the-job support.
The Postal Service is a great place to work, with job security, career advancement opportunities and benefits. The Postal Service has an immediate need for the following positions to be filled:
Applicants must be 18 years or older. All applicants must be able to pass drug screening and a criminal background investigation. Some positions require an exam. Any position that has a driving requirement will also require a valid driver license and clean DMV two-year driving history. Citizenship or permanent resident status is required.
The Postal Service is an equal opportunity employer offering a fast-pace, rewarding work environment with competitive compensation packages, on-the-job training, and opportunities for advancement. Learn more at: Careers – About.usps.com.
Join us for the 3rd Annual National Night Out AND a Back-to-School Supply Giveaway — all in one FREE, family-friendly celebration. Meet your local police officers. Bounce houses & games. FREE school supplies for students (while supplies last). Music, food & fun for all ages!
National Night Out is an annual community-building campaign that promotes police-community partnerships and neighborhood camaraderie to make our neighborhoods safer, more caring places to live. National Night Out enhances the relationship between neighbors and law enforcement while bringing back a true sense of community. Furthermore, it provides a great opportunity to bring police and neighbors together under positive circumstances.
Millions of neighbors take part in National Night Out across thousands of communities from all fifty states, U.S. territories and military bases worldwide on the first Tuesday in August (Texas and select areas celebrate on the first Tuesday in October). Neighborhoods host block parties, festivals, parades, cookouts and various other community events with safety demonstrations, seminars, youth events, visits from emergency personnel, exhibits and much, much more.
Performances will be at Prewett Family Park not in Rivertown this year
Date(s): Thursdays, August 7, 14 & 21 Time(s): 6:00pm-8:00pm Location: Antioch Community Center Amphitheater at Prewett Family Park
By City of Antioch Recreation Department
Are you ready to experience the ultimate summer vibes? As the sun sets, the real magic begins. Picture yourself surrounded by friends and family, a cool summer breeze, and the rhythmic beats of live music. All for FREE!
Although it’s entitled the Rhythms by the River Concert Series it won’t be in Antioch’s historic, downtown Rivertown next to the river. Instead, this year, the performances will be at Prewett Family Park in the Antioch Community Center Amphitheater at 4703 Lone Tree Way.
Hot August Thursdays prepare to be serenaded by a diverse range of artists and bands, covering genres from rock, pop, and country to Motown, R&B, today’s hits and much, much more. Our carefully curated lineup promises to keep you grooving all evening long and includes Nzuri Soul on Aug. 7th, The Houserockers on the 14th and Groove Ride on Aug. 21st.
Elevate your concert experience with a delicious array of culinary delights, brought to you by Foodie Crew. Indulge your taste buds each Thursday with food options from all around the Bay Area. From savory to sweet, there’s something for every palate. Want to know the food options ahead of time? Visit www.foodiecrew.com.
August 7 – Nzuri Soul
Country loving, R&B, Soul-Rock singer Nzuri Soul will perform Thursday, Aug. 7, 2025. Source: City of Antioch.
Born in Texas, raised in the Bay Area, Nzuri Soul is a Country loving, R&B/Soul-Rock singer based in California who has made a name for herself over the course of her ten-year career in the music industry with her powerful vocals, songwriting, and entertaining stage presence. She has released three full albums as well as a holiday album.
Nzuri Soul is no stranger to performing at iconic California venues like Oakland’s Fox Theatre, House of Blues (Los Angeles, New Orleans & Las Vegas), The Fenix Club, The Empress Theater, Journey Theatre Vacaville, Downtown Theatre Fairfield, Marina Lounge, and Vino Winery just to name a few. In the last few years Nzuri Soul and her band have had several sold-out tribute shows at Yoshi’s Oakland to Aaliyah, Beyonce, Mary J Blige, Tina Turner, Aretha Franklin and Gladys Knight.
Nzuri Soul and her band have been awarded NCEMA “R&B Band of the Year” 2018 & 2019, “Entertainer of the Year” 2019 & 2020 BMA “R&B Female Singer of the Year” and “Best Female Live Performer.” Nzuri Soul and her band are known for bringing a tight knit, all in dance party and her shows are always dedicated to the fans that have kept her career a success. www.instagram.com/nzurisoulbandwww.instagram.com/nzurisoulmusic
Every trip matters! No matter if you’re driving to work, catching BART, biking to school, or strolling your neighborhood, we have a plan to make traveling around our county easier, safer, and smarter.
The Contra Costa Transportation Authority (CCTA) is updating your Countywide Transportation Plan (CTP), and we’re asking residents to weigh in on the next 25 years of investments that will keep our communities moving smoothly and sustainably.
What’s on the Table?
In 2024, CCTA surveyed residents to find out what transportation solutions were most needed in their Contra Costa community — and thousands of you responded! Public engagement in early 2025 identified strategies for improving transportation
Based on your feedback, CCTA has created a series of Transformative Visions — bold project and program ideas that are visionary and will bring safer streets, more reliable transit, cleaner air, and more access to good transportation options for every corner of Contra Costa County. Your feedback will help us refine these ideas and decide which deserve top priority.
These visions are:
Create People-First Transportation Spaces: Redesign streets to put people first, making everyday travel safer, easier, and more comfortable.
Provide a Complete, Reliable Transit Network: Expand fast and reliable bus, shuttle, rail, and ferry services that come more often and connect you to key places.
Provide Reliable Freeway Travel: Keep freeways moving smoothly by reducing backups from crashes, better using existing travel lanes, and fixing bottlenecks.
Build Vibrant Communities: Revitalize and create places where people can live, gather, and connect to natural and community destinations.
Learn more about these Transformative Visions. Complete this brief survey to tell us which best fits YOUR vision for Contra Costa County. Your feedback will help us refine and update these Transformative Visions to show what the Plan’s focus should be for transportation investments in the next 25 years.
Why Take the Survey?
Influence real projects. Your answers guide where billions in transportation funds are spent.
It’s quick. The survey is mobile-friendly and takes just a few minutes.
Perks! Complete it and you can enter a drawing to win one of five $100 virtual Visa gift cards—the sooner you participate, the more chances you’ll have to win.
Survey window. The questionnaire is open through September 30, so don’t wait.
We greatly appreciate your feedback. Individuals who complete this survey may enter a drawing to win one of five $100 virtual VISA gift cards. Winners’ names will be drawn throughout the survey period, so the earlier you take the survey, the more chances you will have to win! The survey is open through September 30.
Set along the scenic waterfront on G Street in historic, Downtown Rivertown, this juried outdoor market takes place alongside the popular Antioch Farmers Market and features handcrafted goods from talented local artisans.
Spaces are limited and fill quickly — don’t miss out.
Click here to apply and secure your spot in this vibrant community event!
Angel G. Luévano. Photo by Luis Nuno Briones. Source: Todos Unidos
Luévano Consent Decree determined in 1981 written civil service test unfair to Black and Hispanic applicants
“Today, the Justice Department removed that barrier and reopened federal employment opportunities based on merit—not race.” – U.S. Assistant Attorney General Harmeet K. Dhillon on Aug. 1, 2025.
“The Decree has had its usefulness and a tremendous effect on the country. Millions of minorities and women hold jobs because of that class action lawsuit. It wasn’t DEI. It didn’t just benefit minorities and women. The (alternative) Outstanding Scholar Program…was actually used 70% by whites.” – Angel Luévano
By Allen D. Payton
On Friday, August 1, 2025, Assistant Attorney General Harmeet K. Dhillon announced that the Civil Rights Division of the U.S. Department of Justice (USDOJ) had ended a 44-year-old decree mandating race-based government hiring. It’s named for Antioch resident Angel G. Luévano, who, with a group of attorneys in 1979, brought a class action lawsuit on behalf of African Americans and Hispanics over the Professional and Administrative Career Examination (PACE). They claimed disparate impact against them based on their test results violated Title VII’s equal employment opportunity provision of the Civil Rights Act of 1964. Dhillon claimed the decree “imposed draconian test review and implementation procedures” on the Office of Personnel Management (OPM).
The 1979 Luévano v. Campbell lawsuit, against the then and first Director of the Officer of Personnel Management, Alan Campbell, resulted in a settlement during the final days of President Jimmy Carter’s Administration, just prior to President Ronald Reagan’s inauguration, eliminating use of the PACE test. According to court documents filed in March 2025 by the USDOJ, “on January 9, 1981, after two years of litigation, Plaintiffs and OPM jointly moved for ‘an order granting preliminary approval to a Consent Decree.’ Luevano, 93 F.R.D. at 72. The parties signed the Decree eleven days prior to the change in administration, and the Court accepted the Decree on February 26, 1981.”
In addition, according to the Civil Rights Litigation Clearing House Case Summary, in the Decree the “federal government in part agreed to…establish two special hiring programs, Outstanding Scholar and Bilingual/Bicultural.”
The lawsuit title was later changed to Luevanov. Ezell, named for Charles Ezell, the current Acting OPM Director. This year’s court filing reads, “Federal law requires many federal jobs be filled based on merit alone. Beginning in 1974, OPM employed a test to do just that. The Professional and Administrative Career Examination (‘PACE’) was a challenging, written examination that measured cognitive and other skills. It quickly proved an effective way of predicting future job performance, thereby increasing the efficiency and capability of the federal workforce. But it did not last long.”
In a Aug. 1 post on Dhillon’s official X (formerly Twitter) account she wrote, “Another federal government DEI program bites the dust! Today, the @CivilRights Division ended a 44-year-old decree that bound the federal government to use DEI in its hiring practices” and shared the news release from the USDOJ announcing the end to the decree:
“Today, the Justice Department’s Civil Rights Division ended a court-imposed decree initiated by the Carter administration, which limited the hiring practices of the federal government based on flawed and outdated theories of diversity, equity, and inclusion.
In Luevano v. Ezell, the Court dismissed a consent decree based on a lawsuit initially brought by interest groups representing federal employees in 1979. The decree entered in 1981 imposed draconian test review and implementation procedures on the Office of Personnel Management—and consequently all other federal agencies—requiring them to receive permission prior to using any tests for potential federal employees, in an attempt to require equal testing outcomes among all races of test-takers.
“For over four decades, this decree has hampered the federal government from hiring the top talent of our nation,” said Dhillon. “Today, the Justice Department removed that barrier and reopened federal employment opportunities based on merit—not race.”
“It’s simple, competence and merit are the standards by which we should all be judged; nothing more and nothing less,” said U.S. Attorney Jeanine Pirro for the District of Columbia. “It’s about time people are judged, not by their identity, but instead ‘by the content of their character.’”
Luévano Responds
In response to the decree’s dismissal, Luévano said, “I agreed to vacate the Decree through the Mexican American Legal Defense and Education Fund (MALDEF) because I don’t want to make bad law. There are two interveners on the other side that wanted to broaden the attack.”
Asked when he agreed to it, he said, “Last week. Attorneys for both sides met with the judge last Thursday to resolve the matter.”
“The Decree has had its usefulness and a tremendous effect on the country,” Luévano continued. “Millions of minorities and women hold jobs because of that class action lawsuit. The Decree affected 118 job classifications in federal hiring nationwide.”
“I’m extremely proud of the effect that it has had on federal hires and getting minorities and women into federal jobs,” he stated. “It affected my decision to join, it was the key for me to join federal civil rights compliance in the Labor Department.”
Asked why he was the lead plaintiff he said, “I took the PACE exam because I wanted to get into a federal job. I achieved an 80 on the test – a passing grade, even though it’s been reported I flunked the exam. That’s not true. The result was I did not get referred to federal openings. They were only referring people with a 100 on their tests to jobs.”
“I learned about the case through the Legal Aid Society which had brought many cases in the construction industry. Our unit was successful in getting the Freedom of Information Act (FOIA) to be effective. I went to them and said, ‘that happened to me’ in the Office of Personnel Management. That’s the lead HR department in the federal government. They’re the gatekeepers to federal employment.”
“I asked them, is there something we can do about this. They said, ‘funny you should ask. We are looking for someone to do something about this’ and we began working on the lawsuit,” he shared.
“One of the things I was able to achieve was alternatives to merit selection in federal employment, the Outstanding Scholar and Bilingual/Bicultural programs that each agency implemented,” Luévano stated.
“I gave up back pay and also the class, to get them to agree to the decree,” he continued. “When you win a case, you usually get a settlement. But I was the one who gave up back pay for myself and for the class to get those two remedies. That was really big. That is huge. Who gets alternatives to merit-based hiring at the national level? They used it to bring in minorities and women.”
“It wasn’t DEI. It didn’t just benefit minorities and women. The Outstanding Scholar Program as an alternative to discriminatory merit-based hiring was actually used 70% by whites,” he stated. “But that’s OK. I wanted to crack the discriminatory employment barriers to federal hiring.”
“When I was in D.C. I met with the second in command at the OPM, while we were in Puerto Rico. He said, ‘Angel, you know it’s not what you know. It’s who you know. I said to him, ‘I know you!’ He replied, ‘But I don’t have any power.’ I’ve learned that every where I’ve gone. As you go up the ladder it gets narrower and narrower and harder and harder.”
“We used the impact theory to prove there was discrimination. There are only two theories, that one and disparate treatment,” Luevano explained.
“I negotiated through my lawyers,” he continued. “We had a lot of attorneys. They included the Lawyers Committee for Civil Rights out of D.C., MALDEF, the Puerto Rican Legal Defense Fund, NOW, and the Legal Aid Society of Alameda County where I worked out of Oakland as a senior law clerk in the impact litigation unit.”
He started as a summer management intern with the General Services Administration as a GS-5 employee in 1972 while in law school. Then he went to work for the Department of Defense compliance division in Burlingame.
They merged all the compliance divisions under the Labor Department.
“They leaped me from a GS-9 to a 12,” he stated. “So, I skipped 10 and 11. I met all of the qualifications.”
He ultimately rose to the level of a GS-15 as Deputy Director of Program Operations for the Labor Department’s Office of Federal Contract Compliance Programs.
“I was number four in the agency nationwide and retired after 30 years in government,” Luevano shared. “That happened to a guy who wouldn’t have even gotten into a federal job because of PACE. Yet, I was qualified, I earned it and I moved up.”
“I had a great career. I helped write the regulations on how to detect employment system discrimination and I trained the trainers nationwide,” he continued. “That was because of my law background. I went to Hastings for four years. Even though I don’t have the degree, I have the equivalent of a Master’s in Law.”
About the timing for the lawsuit settlement Luévano shared, “Our lawyers showed up. Their lawyers showed up, the attorneys for the outgoing Carter Administration. The attorneys for the Reagan Administration showed up and wanted to put a stop to the resolution of the Consent Decree. The judge said, ‘No, you’re not in power, yet.’”
“We were all happy, we signed the Decree and made history,” he stated. “I’m humbled by this tremendous achievement.”
Luévano was recognized for his efforts at one of the conferences of LULAC, the League of United Latin American Citizens, in which he later rose to the level of California State Director and V.P for the Far West. Image de California gave him an award during one of their conferences at which he spoke about the Consent Decree.
“If we hadn’t accomplished that we’d still be back in the dark ages of discrimination,” Luévano stated.
“I’m actually writing a book, a memoir about it,” he added. “I’m working with Harvard on that.”
He and his wife Argentina have been involved in the Antioch community with the Kiwanis Club of the Delta-Antioch, where he was president last year and Argentina is currently secretary. They both also served as Lt. Governors for the organization in Division 26, Area 9 in Northern California. Then Angel was elected as Trustee for the entire Division which includes California, Nevada and Hawaii.
In addition, since May 2004, Angel has also served as Executive Director for Todos Unidos, an Antioch-based non-profit organization established to raise the educational, economic, health and social outcomes of underserved communities along the Suisun Bay and the greater San Joaquin Delta area.
