U.S. Senator Bill Cassidy of Louisiana appears to have remembered he represents the Bayou State and not special interest groups like Big Pharma in Washington D.C. On Monday, he issued a press release stating he'd sent letters to two major pharmaceutical companies asking why they are refusing to comply with federal law.

I’ve covered this issue a lot here at RedState, and a lot of that has been focused on Louisiana for the obvious reason that I live here and host a radio show here, it’s one of the states that has passed state-level protection of the 340B program, and our Senator Bill Cassidy is the ranking member on the Senate HELP Committee. But the recent press release is quite the turnaround from where Cassidy was as far back as... February.

For at least five years, Cassidy has been trying to severely rein in the 340B drug discount program, which as previously noted here now benefits a ton of rural, working-class people in red states—like, well, Louisiana. Some defenders of that program would say Cassidy’s efforts have been so drastic that “kill the program” is a better description of what he is trying to do than even just “rein in.”

Cassidy’s opposition to the program goes back a ways. A bill he introduced in 2018 would have banned new enrollments by hospitals in 340B for two years, flat out. His press release about it literally says, "The bill would prohibit new enrollments in the 340B program for at least two years..." 

In July 2023, Cassidy wrote an anti-340B op-ed that complained that the program “costs pharmaceutical companies billions.” Let’s set aside the tone-deafness of complaining about Big Pharma poverty at a time when most conservatives’ eyes were popping out about the huge profits Big Pharma had made in the wake of things like vaccine mandates, new anti-obesity drugs coming online, and more. 

It’s hard not to wonder if Senator Cassidy’s newfound interest in standing up for Louisianans is linked to the fact that the 2026 election is creeping closer. His recent actions might seem like an effort to remind us that he represents Louisiana in Washington, D.C., but it’s worth asking if this press release is more than just political posturing. 

Beginning in 2020, several drug manufacturers announced restrictions on covered entities dispensing 340B drugs to patients through multiple contract pharmacies, stating the restrictions would cut down on unlawful duplicate discounts and diversion of 340B drugs to ineligible patients. These restrictions limit covered entities’ ability to dispense 340B drugs from more than one contract pharmacy.  

Given that Eli Lilly and Amgen are among the manufacturers imposing restrictions on covered entities, Cassidy is requesting information to better understand the companies’ justifications for the restrictions and how the restrictions affect distribution of 340B drugs.  

The 340B program, which provides affordable medication to rural communities and supports local hospitals, is crucial for Louisiana—especially since the state has passed laws protecting the program at the local level.

Despite his current stance, Senator Cassidy has historically worked to weaken this program at the national level, often appearing out of step with his constituents who rely on it. As the ranking member on the Senate HELP Committee, his influence in shaping healthcare policies is significant, making his recent actions worth examining more closely.

In his letters, dated September 13th, Cassidy requested that Eli Lilly and Amgen disclose all internal communications regarding their decisions to impose restrictions on distributing 340B drugs to contract pharmacies, asking for a response by October 15th. This move raises an essential question: Is Cassidy finally committed to holding Big Pharma accountable, or is this merely an attempt to curry favor with voters who overwhelmingly support the 340B program?

As we wait to see whether Senator Cassidy genuinely challenges the pharmaceutical giants or merely continues his history of siding with them, Louisianans deserve more than just rhetoric. They need real advocacy that goes beyond campaign posturing, especially when the stakes are as high as access to affordable medication and healthcare.