Real bill currently in Congress  c/o  S/119/5244

SUSTAIN 340B Act

Policy area: Health ▲ 30 days since action Sponsor: Jerry Moran, KS-Senate, R → Congress.gov

Latest action (2026-08-05): Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

The Framers

“Founders’ Verdict”

CONSTITUTIONAL

Confidence 0.50

Synthesis

The bill is constitutional as a valid exercise of Congress's power to regulate interstate commerce under Article I, Section 8, Clause 3, and its power to spend for the general welfare under Article I, Section 8, Clause 1. The drug discount program affects interstate commerce and conditions on federal funds are permissible. The Necessary and Proper Clause supports the means chosen. The majority holds that the bill does not exceed enumerated powers or violate federalism principles, as it operates within federal authority over commerce and spending.

Hamilton YES

The bill to amend the Public Health Service Act concerning the drug discount program falls within the constitutional authority of Congress to regulate commerce among the several states and to provide for the general welfare. The regulation of pharmaceutical pricing and distribution directly affects interstate commerce, as drugs are widely traded across state lines. Moreover, the Congress may attach conditions to the receipt of federal funds under its spending power, as the drug discount program is a federal program that disburses public money. The requirement that drug manufacturers participat…

Article I, Section 8, Clause 1 (General Welfare Clause) Article I, Section 8, Clause 3 (Commerce Clause)
Jefferson NO

This bill exceeds the limited powers delegated to the federal government by the Constitution. The power to regulate health care and drug pricing is not among the enumerated powers in Article I, Section 8, and is therefore reserved to the states and the people under the Tenth Amendment. The Commerce Clause cannot be stretched to cover such a matter without doing violence to the original understanding of that clause. The federal government's role must be strictly confined to its delegated duties, and this legislation intrudes upon the police powers of the states.

Amendment X Amendment IX
Madison CONDITIONAL

The proposed bill, amending the Public Health Service Act to alter the drug discount program, must be examined through the lens of enumerated federal powers. The Congress may regulate commerce among the several states, and a drug discount program that operates across state lines could fall within that authority. However, the Constitution does not grant a general power to regulate prices or to impose conditions on private contracts absent a clear nexus to an enumerated power. If the bill merely adjusts the terms of a federal program that conditions participation in interstate commerce on compli…

Article I, Section 8, Clause 3 (Commerce Clause) Federalist No. 45
Marshall YES

The bill to amend the Public Health Service Act with respect to the drug discount program is a constitutional exercise of Congress's power to regulate interstate commerce and to make all laws necessary and proper for executing that power. Drugs are articles of interstate commerce, and a discount program affecting their distribution falls within the broad definition of commerce under Gibbons v. Ogden. Moreover, McCulloch v. Maryland establishes that Congress may employ any appropriate means to achieve legitimate ends, and the Necessary and Proper Clause supports this legislation as a reasonable…

Article I, Section 8, Clause 3 Article I, Section 8, Clause 18 Gibbons v. Ogden (1824) McCulloch v. Maryland (1819)

What should pass

“AI Consensus Solution”

No solution yet

Daily synthesis runs at 06:00 UTC. This bill's consensus draft will appear on the next pass.

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