REPORT: Hospitals Capitalize on Federal Program While Sheltering Billions Offshore

Washington, D.C. (October 21, 2025)—Ahead of a congressional hearing this week investigating the 340B Drug Pricing Program, the Job Creators Network (JCN) is releasing a new report that finds hospitals participating in the federal initiative are stashing billions of dollars outside the U.S. The accounting trick is not illegal, however, some argue that the 340B program helps to enable the practice because it acts as a major revenue stream for hospitals at the expense of small businesses and patients. 

JCN researchers examined the publicly available tax returns of roughly 50 hospitals across six states—including Michigan, Ohio, Massachusetts, Illinois, New York, and Washington—and found that more than $17 billion is sitting in offshore accounts. While these institutions are keeping large sums of money outside the U.S., the federal 340B program has ballooned by more than $35 billion since 2010, according to the Congressional Budget Office.

Read the full report here.

“Like many government initiatives, a lack of oversight and transparency has allowed the 340B program to go off the rails,” said Job Creators Network CEO Alfredo Ortiz. “Rather than being a lifeline for low-income communities to access discounted medicine, the program has morphed into a cash cow for hospitals at the expense of small businesses and patients. Given that billions of dollars are being stashed offshore by 340B entities, policymakers have a responsibility to open up the federal program’s hood to see what’s going on.”

The takeaways of the report align with what the Senate Health, Education, Labor and Pensions (HELP) Committee—chaired by Sen. Bill Cassidy (R-LA)—has already concluded about 340B. In April, the committee released the findings of a years-long investigation that suggested participating hospitals are taking advantage of the program’s lack of transparency to generate revenue. Thursday’s hearing will further evaluate the degree to which the 340B program is—or is not—working, and opportunities for reform. 

BACKGROUND ON THE SMALL BUSINESS CRISIS: JCN has long advocated for healthcare reform that would help to address the affordability crisis facing small businesses. As healthcare costs continue to rise—in part because of out-of-control government initiatives like the 340B program—small employers are forced to absorb the rising prices when sponsoring medical coverage for employees. To address ballooning costs for our small businesses, JCN advocates for injecting more transparency and competition into the system. Expanding the use of Health Savings Accounts for direct primary care, as Republicans accomplished earlier this year, and thinning regulations for Association Health Plans are two examples.