DC EKG with Joe Grogan

Episode 137: Tax Expenditures, 340 B Drug Pricing, and Kidney Donation Reform

Air Date: June 15, 2026

Episode Description

In this episode, Joe Grogan sits down with Dr. Ike Brannon, President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation, to discuss hidden tax expenditures, the 340 B drug pricing program, and innovative solutions to the kidney shortage crisis.

Dr. Brannon brings decades of Capitol Hill experience, including roles as chief economist of the House Energy and Commerce Committee and senior advisor to Senator Orrin Hatch. He and co-author Tony LoSasso recently published groundbreaking research in Health Affairs Forefront arguing that the 340 B drug pricing program should be classified as a hidden tax expenditure costing the federal government 15 to 20 billion dollars annually.

The conversation covers how the 340 B program evolved from providing discounted drugs to uninsured patients into a massive subsidy for nonprofit institutions with little benefit to poor patients. Dr. Brannon explains how the same drug acquired at a 340 B discount often results in full commercial copays for patients.

Joe and Dr. Brannon explore other problematic tax expenditures including the mortgage interest deduction, employer health insurance exclusion, and credit union tax breaks. The episode pivots to Dr. Branons passionate work on kidney donation reform. Forty-five thousand Americans die annually from end stage renal failure due to kidney shortage, disproportionately affecting African Americans. Dr. Brannon advocates for fully reimbursing kidney donors for all expenses.

Key Topics

340 B drug pricing program, tax expenditures, pharmaceutical discounts, nonprofit hospitals, mortgage interest deduction, kidney donation, end stage renal failure, organ shortage, entitlement reform, social security, Medicare, federal deficit, health economics

Key Timestamps

0:00 Opening: What should be in a reconciliation bill?

4:38 The 340 B drug pricing program explained

13:54 How the 340 B discount does not reach patients

20:13 Mortgage interest deduction: the most irritating tax break

31:00 Prospects for reconciliation under Trump administration

34:57 The kidney donation crisis: 45,000 deaths per year

39:02 How kidney donation reimbursement would work

40:00 Would you allow kidney sales? The ethical debate

45:13 Final thoughts

About the Guest

Dr. Ike Brannon is President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation. He holds a PhD in Economics from Indiana University. Dr. Brannon served as chief economist of the House Energy and Commerce Committee, senior advisor to Senator Orrin Hatch on tax and trade policy, and has worked at the Congressional Joint Economic Committee, Treasury Department, and for the McCain presidential campaign. He is founder of the Prosperity Caucus and focuses on growth-oriented economic policy and healthcare innovation.

Featured Research

The 340 B Drug Pricing Program is a Hidden Tax Expenditure

Health Affairs Forefront, April 24, 2026

Co-authored by Ike Brannon and Tony LoSasso

https://www.healthaffairs.org/content/forefront/340b-drug-pricing-program-hidden-tax-expenditure

Podcast: DC EKG with Joe Grogan

Episode: 137

Guest: Dr. Ike Brannon

Sponsor: Survivors for Solutions

Producer: Stay on Course Studios

Executive Producer: John CZ Czwartacki, DC EKG Podcast