The hidden hospital scam driving up drug prices, coming to a state near you



Kansas lawmakers are debating whether to expand health care providers’ access to the federal 340B drug pricing program. If passed, Senate Bill 284 would hand even more power to large hospital chains while shrinking consumer choice. It would also deepen the program’s existing problems — lack of accountability, rising costs, and market consolidation — all without helping the patients it was supposed to serve.

The 340B program, created in 1992, was meant to help safety-net providers serving uninsured and low-income patients by requiring drug manufacturers to sell medications at steep discounts. Today, it has ballooned into the second-largest prescription drug purchasing program in the United States, behind only Medicare Part D, costing $66.3 billion in 2023.

The 340B program no longer fulfills its stated purpose. It fuels industry consolidation, drives up costs, and reduces access to care — especially in rural communities.

SB 284 would make that worse. The bill would block drugmakers from denying access to certain drugs, reduce transparency, and discourage innovation. It would do nothing to stop hospitals from exploiting the program. Instead, it would encourage them to expand the same practices that drive up costs for Kansans, small businesses, and rural health care providers.

The 340B shell game

The myth behind 340B is that big health systems use their windfalls to support rural hospitals. The reality is the opposite. As 340B has expanded, rural hospitals have closed by the dozens. The law’s original purpose — to subsidize drug purchases for clinics that serve the needy — has been lost.

What began as a narrow, temporary safety net for vulnerable populations has evolved into a profit engine for massive hospital systems. Many 340B participants today are large urban hospitals, cancer centers, and wealthy institutions that do little charity care. Once a hospital buys an outpatient clinic, it can immediately declare that clinic 340B-eligible, regardless of the patients it serves. Those discounted drugs can then be billed at full price to insurers or government programs, and the hospital keeps the difference.

Federal watchdogs, including the Government Accountability Office and the Office of Inspector General, have repeatedly documented the program’s lack of oversight. Hospitals aren’t required to report how they use 340B revenue or whether they pass savings on to patients.

The rich get richer

Hospitals buy drugs cheap, bill high, and pocket the profits. Those profits fund expansion — not lower costs for patients. The lure of easy money drives hospital consolidation across the country. Smaller, independent clinics — often more efficient and affordable — can’t compete with heavily subsidized giants and are forced to sell out.

This pattern has repeated hundreds of times nationwide, inflating 340B spending and diverting subsidies far from the low-income patients the program was meant to help. Since 2014, when 340B abuse accelerated alongside the Affordable Care Act, nonprofit hospitals have gone on a buying spree, snapping up local clinics, raising prices, and squeezing out independent providers.

Each participating hospital can also contract with hundreds of retail pharmacies, creating sprawling networks that capture 340B discounts far removed from any needy patient. The result is “mission creep” on a massive scale — a program once justified by compassion now serves as a revenue stream for billion-dollar systems.

Instead of cutting costs, 340B creates a hidden subsidy that enriches institutions while obscuring the real price of care. Worse, some hospitals use their freed-up funds to expand abortion and gender-transition services, sidestepping Hyde Amendment restrictions on federal money for those procedures.

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Photo by Win McNamee/Getty Images

A program beyond saving

The 340B program no longer fulfills its stated purpose. It fuels industry consolidation, drives up costs, and reduces access to care — especially in rural communities. Expanding it in Kansas would cement a broken system, trapping the state in a cycle that benefits hospitals and harms taxpayers.

Congress and the Trump administration are working to reform 340B and Medicare to curb waste and corruption. Kansas lawmakers should follow that lead. Instead of handing big hospital chains another windfall, they should restore accountability, competition, and transparency — so that health care serves patients, not institutions.

AI isn’t feeding you



Mason County, Kentucky, sits just an hour from Cincinnati but feels like another world. Its beautiful rolling hills, deep farming roots, and traditions make it a bastion of conservative culture. Trump carried the county by 44 points. Residents distrust globalism, Big Tech, and government collusion.

Yet Mason has become the latest target for one of the largest data centers in the world. The company behind it hides its name, cloaks officials in nondisclosure agreements, and dangles cash at landowners while refusing to reveal how it will feed the massive hunger for power and water.

The question now is whether Kentucky — and America — will heed the warning or allow ‘progress’ to consume the very land, food, water, and power that make progress possible.

The plan calls for a sprawling 5,000-acre “technology campus” near Big Pond and Tuckahoe roads. Local officials admit the buyer is a Fortune 20 giant, described only as a “global, top 10” company with “hundreds of thousands of employees.”

Residents say the tactics are familiar. A few landowners get offers — $35,000 an acre in this case — while the broader community is left to bear the burden: displaced farmland, strained resources, and declining property values. Good luck selling to anyone but the data-center developer once the deal is in motion.

Power drain

The proposed complex in Maysville would demand 2.2 gigawatts of power, starting at 110 megawatts by 2026 and hitting full capacity by 2028-2031. That’s the annual energy use of 1.8 million American homes. For a county of 17,000 people, the numbers are staggering. The project alone would nearly double the East Kentucky Power Cooperative’s yearly output.

And that’s before accounting for water. Data centers require enormous cooling systems that siphon off local supplies. Add in the direct loss of 5,000 acres of farmland and timberland — in a nation already facing record-low cattle herds and shrinking food security — and the price tag for “progress” keeps rising.

By comparison, the average coal plant sits on 585 acres; a natural gas plant, only 30. Those facilities power the nation. This one would devour power and water to feed servers.

A national trend

This isn’t just about Mason County. Hyperscale data centers are sprouting everywhere with the help of state and federal officials eager to rezone farmland. Twenty such facilities are already planned for Kentucky, 10 for Ohio, and 35 for Indiana. Each site removes productive farmland, stresses infrastructure, and hands more of the food and energy supply to giant corporations.

The sales pitch is always the same: jobs and economic development. Yet the real math looks different. The U.S. lost more than 100,000 beef-cow operations between 2017 and 2022. Farmers face higher feed costs, tighter margins, and competition from giant meat-packers. Now, Big Tech threatens to take what’s left.

Cronyism exposed

Mason County Judge-Executive Owen McNeill and other officials signed NDAs while promoting the deal. Residents see it for what it is: promises of prosperity in exchange for their land, heritage, and way of life. On Facebook, 1,500 locals in “We Are Mason County” compare it to a Nigerian prince scam — big promises, little proof, and huge risks.

The scam extends to Frankfort. House Bill 775 exempts data centers from Kentucky’s 6% sales and use tax for 50 years. Servers, networking equipment, cooling systems — all tax-free. Farmers pay sales tax on every tractor and plow, but Google and Meta lobbied for an endless free ride.

RELATED: Time to pump the brakes on Big Tech’s AI boondoggle

Photo by BlackJack3D via Getty Images

Land, food, water, power

At stake are the four essentials of civilization. Land grows food. Water sustains life. Power keeps the lights on. Once given away, none of these can be reclaimed. The boosters of artificial intelligence say America must have the infrastructure for it at any cost. But if AI can’t survive without tax breaks, secrecy, and the seizure of farmland, maybe it isn’t the inevitable juggernaut Silicon Valley claims.

Mason County itself bears the name of George Mason, the anti-Federalist who warned that monopolies in trade and commerce would mean “no Security for ... the People for their Rights.” He did not live to see global monopolies seizing farmland in Kentucky, but he predicted the danger.

The question now is whether Kentucky — and America — will heed the warning or allow “progress” to consume the very land, food, water, and power that make progress possible.

Big Tech colonization is real — zoning laws are the last line of defense



How much of America’s rural landscape, power, water, quality of life, and heritage will be wiped out by one industry — AI data centers? Big Tech firms won’t say. Evidently, it’s as much as we’re willing to tolerate.

David Sacks and his Silicon Valley allies know the stakes. They tried to slip a provision into the One Big Beautiful Bill Act to block all zoning and regulation of AI facilities. Why? Because the only way to cover the country with thousands of hyperscale data centers is to turn rural America into one giant industrial park — with no transparent public plan, no limits on power or water use, and no end in sight.

Zoning remains one of the few tools citizens can use to say no — not just to data centers, but to the entire agenda of unaccountable technocracy.

Before Mark Zuckerberg’s Manhattan-sized complexes even break ground, the United States is already on track for these facilities to consume more energy annually than Poland — a nation of 36.6 million people — used in 2023. That’s not a tech “footprint.” That’s a tech crater.

But a counterrevolution is building.

Loudoun County: The canary in the coal mine

If you want to see America’s future under digital colonization, look at Loudoun County, Virginia. The growth of hyperscale data centers there is so unnatural that some neighborhoods now want to rezone themselves as industrial just to escape.

Patricia Cave says life in her Arcola neighborhood has become impossible, as she and her neighbors have become essentially barricaded by server farms.

“Living on Hiddenwood Lane is no longer an option,” Cave told the Loudoun County Board of Supervisors last year. “We can’t be victims again to political winds that are bigger than us — and we can’t be a human buffer.” The only way she and her neighbors can sell their homes — at pennies on the dollar — is to convert them to industrial property.

Just 10 years ago, Cave’s neighborhood was ringed by rural farmland. Now, with 200 data centers covering roughly 49 million square feet in what’s known as Data Center Alley, you can’t escape their reach. About one-third of Loudoun County’s data centers now sit near residential areas.

Frederick County: Drawing a line

In Frederick County, Maryland, officials saw the writing on the wall and set a hard limit: No more than 1% of the county’s landmass can be used for data centers. It’s a rare example of local government acting to protect the character, environment, and livability of their communities before the tech giants could hollow them out.

Monroe County: Fighting for their ground

In Monroe County, Georgia, residents fought off a proposed rezoning that would have put a massive data center next to homes and farms. The company behind it claimed it would bring jobs. Locals pointed out the reality: a handful of maintenance workers, huge power demands — 1.1 gigawatts, more than the daily usage of a million households — and a future of noise and light pollution.

Residents won — for now.

The pattern is clear

Local victories are more the exception than the rule. The reality is that Big Tech companies are expanding across America with little or no resistance.

Tech companies claim these facilities are the backbone of the future. In reality, they’re engines of resource consumption — each one sucking up hundreds of millions of gallons of water and enough electricity to power the equivalent of large cities in counties with populations in the low five figures.

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Photo by blackdovfx via Getty Images

Meta, for example, wants to drop a 1.2-gigawatt behemoth in tiny Cheyenne, Wyoming — enough juice for 1 million homes. In drought-stricken Texas, Microsoft, OpenAI, and others are pushing the Stargate project, a cluster of hyperscale data centers around Abilene that would guzzle the power of millions of homes and drain staggering amounts of water. Smaller facilities in Texas have already consumed 463 million gallons in 2023 and 2024.

The profits leave town. The costs — environmental, economic, and social — stay behind.

But the real danger is Washington overriding local efforts to preserve local residents' way of life. If Congress strips away zoning authority in the name of “progress,” the only “progress” will be toward an industrialized, unlivable countryside.

Why zoning matters

Public zoning meetings are the last places where ordinary citizens can stop these projects. Federalizing control would silence local voices. In court, zoning remains one of the few tools citizens can use to say no — not just to data centers, but to the entire agenda of unaccountable technocracy.

For once, the stakes are obvious: if we lose local control, we lose the fight. Loudoun County shows what surrender looks like. Frederick County and Monroe County show what resistance can achieve.

It’s time to choose.

Don’t let rural America become the next New York City



Elect strong conservative leaders in your state — or watch it go the way of New York City. That’s the unmistakable warning conservatives should take from New York voters nominating a Hamas sympathizer and self-proclaimed socialist for mayor.

How could this happen just one generation after 9/11? How does the city that suffered most from jihadist terrorism now embrace a foreign-born Islamist who wants to “globalize the intifada”?

When Trump calls for more farm labor from the third world — so long as the workers aren’t 'murderers' — he misses the deeper issue. Violent crime isn’t the only threat.

Several factors explain the city’s decline, but one stands out: immigration. Forty percent of New York City’s population now consists of foreign-born residents — not including the children of immigrants. Mass immigration on that scale, especially from Islamic and third world countries, doesn’t just change the labor market. It imports foreign values and embeds them in the culture.

Trump should think twice about demanding more foreign agricultural workers for red-state America. His arguments about labor shortages miss the larger picture. This isn’t just about harvesting crops — it’s about reshaping schools, neighborhoods, and eventually, the ballot box.

In 2022, the Center for Immigration Studies mapped 2,351 Census Bureau-defined Public Use Microdata Areas to show the percentage of schoolchildren from immigrant households. No surprise: Urban districts in places like New York and Los Angeles show overwhelming majorities of immigrant families.

But that trend now stretches deep into red states. Cities and even rural counties are seeing shockingly high proportions of students from immigrant families.

In southeast Nashville, 65% of public-school students come from immigrant families. Iraq ranks as the second-largest country of origin. In Dallas, all 20 school districts report at least one-third of students from immigrant households. In most of those districts, a majority of families are foreign-born.

This trend extends well beyond major cities. In southwest Oklahoma City, 43% of students come from immigrant families. Greenville, South Carolina, stands at 35%. Birmingham and Chattanooga each hover around 20%.

Red-state cities and midsize towns now reflect immigration levels once limited to coastal urban hubs. That leaves rural America as the last holdout — and even that is changing.

The so-called farm labor trade has transformed heartland communities. These public school districts report the following immigrant family enrollment rates:

  • Texas Panhandle (outside Potter and Randall Counties): 31%
  • Oklahoma Panhandle: 21%
  • Southwest Kansas (Dodge City, Garden City, Liberal City): 55%
  • Central Nebraska: 27%
  • Canyon and Owyhee Counties, Idaho (Caldwell and Nampa): 30%
  • Whitfield County, Georgia: 43%
  • Woodbury and Plymouth Counties, Iowa (Sioux City): 26%
  • Washington County, Arkansas: 26%
  • Fargo, North Dakota: 23%

Until recently, these areas were overwhelmingly native-born. They maintained a strong continuity of American culture and civic tradition.

What happens when the next generation of these children grows up, votes, and brings in more from similar backgrounds? These red counties may not stay red for long.

Mitt Romney won Washington County, Arkansas, by 16 points in 2012. Just 12 years later, Donald Trump carried it by only six — even as he expanded his statewide margin. What changed? More than a quarter of the local student body now comes from immigrant households.

RELATED: New York City’s likely next mayor wants to ‘globalize the intifada’

Photo by ANGELA WEISS/AFP via Getty Images

Trump won rural Sampson County, North Carolina, by a 2-to-1 margin. Yet, by the 2022–23 school year, Hispanic students made up 44.2% of public school enrollment. The district now runs extensive English as a Second Language programs to meet ongoing demand. Even if Hispanic voters shift modestly right, when has such rapid demographic upheaval ever worked to conservatives’ advantage?

The pace of change is impossible to ignore. Importing foreign labor into rural counties inevitably reshapes culture — and, soon after, voting patterns.

Greene County, Iowa, illustrates the point. In 2023, Hispanic residents accounted for just 3.3% of the total population. But that number underrepresents their influence. Iowa State University researchers found Latino populations in rural Iowa tend to skew young, meaning they disproportionately fill the schools even when their overall numbers look small. That imbalance compounds over time.

When Trump calls for more farm labor from the third world — so long as the workers aren’t “murderers” — he misses the deeper issue. Violent crime isn’t the only threat. The more serious loss lies in surrendering the very communities that naturally align with traditional American culture.

As Vice President JD Vance put it during his Republican National Convention acceptance speech: “America is not just an idea. It is a group of people with a shared history and a common future. It is, in short, a nation.”

That is the nation Trump must promise to defend — not just with words but with sound policy.

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The True ‘Threat To Democracy’ Isn’t White Americans, It’s The Democrat Party

[rebelmouse-proxy-image https://thefederalist.com/wp-content/uploads/2024/03/Screenshot-2024-03-01-at-3.45.01 PM-1200x675.png crop_info="%7B%22image%22%3A%20%22https%3A//thefederalist.com/wp-content/uploads/2024/03/Screenshot-2024-03-01-at-3.45.01%5Cu202fPM-1200x675.png%22%7D" expand=1]These 'journalists' have their heads so far up their own keisters, they wouldn't know the honest truth if it punched them in the face.

​'White Rural Rage' authors blast 'anti-gay,' 'xenophobic,' 'anti-democratic,' 'pissed off,' uneducated Trump supporters



The authors of "White Rural Rage: The Threat to American Democracy" blasted the subjects of their book as "anti-gay," "xenophobic," "anti-democratic," "pissed off," uneducated supporters of former President Donald Trump in an interview on MSNBC's "Morning Joe" earlier this week.

What are the details?

The program's smug co-host, Mika Brzezinski, prefaced the segment with authors Tom Schaller and Paul Waldman by wondering why Trump got so much support from rural America when he "became a millionaire at 8 years old and didn't have to serve because he claimed he had bone spurs in his little feet."

The far-left Brzezinski asked with a grin, "Why are white rural voters a threat to democracy at this point? You would think, as we've pointed out, looking at Joe Biden's background and Donald Trump’s, that the opposite would be true.”

Schaller answered that he and Waldman “lay out the fourfold interconnected threat that white rural voters pose to the country" in their new book and then dropped his first bomb.

“They're the most racist, xenophobic, anti-immigrant, anti-gay geo-demographic group in the country," he began. "Second, they're the most conspiracist group: QAnon support and subscribers, election denialism, COVID denialism, scientific skepticism, Obama birtherism.”

Schaller added that white rural Americans hold “anti-democratic sentiments.”

“They don’t believe in an independent press, free speech. They’re most likely to say the president should be backed unilaterally without any checks from Congress or the courts or the bureaucracy," he said. "They're also the most strongly white nationalist and white Christian nationalist. And fourth, they’re most likely to excuse or justify violence as an acceptable alternative to peaceful public discourse.”

Brzezinski asked in quite the elitist tone why the subjects of their book are "vulnerable."

Waldman replied that it has to do with “problematic education systems,” “poorer infrastructure” and “a lack of economic opportunity," most notably a great loss of manufacturing jobs.

“That kind of left them open to someone like Donald Trump who would come along and tell them something that was true — that there is a system that has not served them well,” Waldman added.

“They're pissed off,” Brzezinski offered off camera.

“They are pissed off,” Waldman affirmed, noting that supporting Trump afforded them a way to "channel their rage and anger" and to "give a big middle finger to Democrats."

Amazingly, know-it-all Brzezinski assumed that what white, rural Americans ultimately want is "to be rich."

Schaller didn't seem so sure that was accurate and noted that "they'd rather channel their rage."

'White Rural Rage' looks at the most likely group to abandon democratic norms youtu.be

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