A Snake Bites the Hand That Fed It

President Trump has been reading "The Snake" to rally crowds for a decade. A kind woman takes in a half-frozen snake, warms it, feeds it, nurses it back to health. Her reward? A poisonous bite.

When it comes to the 340B Drug Discount Program, the Trump administration and Health and Human Services Secretary Robert F. Kennedy Jr. have taken care of Big Pharma. Very good care in so many ways.

Secretary Kennedy revived Big Pharma's 340B rebate scheme. On October 1, HRSA, the agency Kennedy oversees, gave 10 drugmakers the green light to start imposing rebates on safety-net providers on January 1. By the government's own estimate, the paperwork comes to nearly 4 million hours a year for safety-net hospitals and clinics, and 352 hours for the super profitable drug companies. When Big Pharma flooded the rebate docket with copy-and-paste comments, HHS let every one of them stand without a flag. Taking care of the snake.

The administration's Justice Department went to court on Big Pharma's side, filing briefs to strike down state laws in Colorado, Rhode Island, Louisiana and Washington that protect patients' access to 340B medicines at their local pharmacies. Taking care of the snake.

When Eli Lilly cut off Tampa General Hospital's discounts for refusing to hand over its claims data, Secretary Kennedy looked the other way. Taking care of the snake.

The administration even exempted most of the drug industry from its new GLOBE Medicare drug pricing model, which ties certain drug payments to prices in 19 other wealthy nations, letting drugmakers that signed a separate Medicaid deal off the hook. CMS's projected savings fell from $11.9 billion to $440 million, and according to CMS, only four manufacturers are still covered. Taking very good care of the snake.

They warmed the snake. They fed the snake. And what did the snake do? Exactly what snakes do. It bit the hand that fed it.

On October 7, drug industry trade group PhRMA hauled the Trump administration into federal court in Washington to kill GLOBE. That is the same model that, by CMS's count, now covers just four manufacturers. Eight of the 10 drugmakers HRSA approved for 340B rebates are PhRMA members. Six days after the administration handed them that favor, their trade association sued the administration.

PhRMA's CEO says the industry "share[s] the administration's goal of ensuring Americans can access and afford their medicines." But watch what they do, not what they say. Take every concession. Pocket every favor. Then sue the moment anything doesn't go their way.

You don't have to support GLOBE to see what this lawsuit reveals. PhRMA's real agenda has never changed. It’s not partnership. It’s not loyalty. It’s not improving access for rural patients. It is protecting Big Pharma's pricing power, whoever sits in the Oval Office.

The administration knew how this story ends. It fed the snake anyway. Do favors for snakes, and you get snakebitten. Every single time.

And the bill for feeding the snake will land where it always does: on America's safety-net hospitals, the rural voters who backed President Trump, and the patients who can't afford to pay it.