340B Program Linked to Higher ACA Silver Plan Premiums, Study Finds

A recent study examined the impact of the 340B Drug Pricing Program on Affordable Care Act (ACA) premiums using data from 2018 to 2022. The analysis focused on the relationship between the density of 340B hospital sites per capita in a county and the benchmark premiums for ACA silver plans. Adjustments were made for other influential factors such as per capita income, unemployment, and hospital market concentration to isolate the specific effect of 340B site density on insurance premiums.

The study employed a multivariate fixed effects regression model incorporating state and year effects. Findings indicated that a one-unit increase in 340B hospital site density corresponded to an approximate 1.1% increase in ACA benchmark premiums. In 2022, the average county-level 340B hospital site density was 1.63, with an average monthly silver plan premium of $500. Accounting for socioeconomic and market variables, the 340B program contributed about 1.8% to the average silver plan premium, equating to an additional $8.90 per month or over $106 annually per subsidized enrollee. These results highlight the 340B program as a meaningful factor influencing ACA premium levels, with implications for cost containment strategies and subsidy budgeting within health insurance markets.