Election Toolkit
With less than three months until the general election, campaigns across the country are in full swing. There’s no better time for essential hospital advocates to educate candidates about issues central to safety net care. We’re here to support you with our online election toolkit, which provides insights and recommendations on how to engage candidates effectively during election season. With 435 seats in the House and 34 seats in the Senate up for grabs, this valuable resource can help you keep your hospital’s needs front and center for new and returning lawmakers.
Fiscal Year 2025 (FY25) Appropriations
As we enter the last months of the 118th Congress, negotiations over federal appropriations for fiscal year (FY) 2025 are at a standstill. Lawmakers are eyeing a stopgap funding measure — possibly, with disaster relief — to avoid a government shutdown on Oct. 1, the start of FY 2025. Funding negotiations likely will depend on the makeup of Congress and the White House after the elections.
After Rep. Kay Granger (R-Texas), stepped down as chair of the House Committee on Appropriations, her replacement, Rep. Tom Cole (R-Okla.), laid out an ambitious plan to pass all 12 funding bills out of the House by August recess. However, while House Republicans were able to pass the funding measures out of committee, only five bills passed out of the House. In addition, the bills passed out of the House contain various policy riders, which make them nonstarters in the Senate.
On the other side of Capitol Hill, Senate appropriators have been working quickly and effectively on their funding bills. Eleven of the 12 appropriations bills have passed out of the Senate Committee on Appropriations and are ready for a vote on the floor, with Homeland Security being the only bill held back, due to conversations surrounding Secret Service budget needs. The bipartisan funding measures in the Senate do not mirror the partisan legislation the House has moved.
End-of-Year Package Outlook
There has been little legislative floor action on Capitol Hill this Congress. Few bills have seen movement in either chamber after coming out of their committees of jurisdiction, and fewer still have made their way to the president’s desk. Even so, given the tremendous amount of work congressional committees have accomplished, an end-of-year package containing health policies relevant to essential hospital priorities could come together during the post-election session of Congress. Issues with potential for end-of-year action, and for which we urge you to advocate to your members of Congress, include these:
Medicaid disproportionate share hospital (DSH) funding cuts
While our advocacy helped eliminate the $8 billion cut to the Medicaid DSH program in 2024, three years of cuts totaling $24 billion remain, and the 2025 cut is set for Jan. 1, 2025. While there is an appetite on Capitol Hill for getting rid of the remaining years of DSH cuts, your advocacy to your congressional delegation will be instrumental in achieving it.
340B Drug Pricing Program
This Congress has featured hearings and bills related to the 340B program, lobbying by the pharmaceutical industry to weaken the program, and efforts by allies to defend it. This is a crucial moment to remind your delegation of how 340B supports your hospital and helps their constituents. Advocate for protective legislation and oppose legislation that weakens the program.
Site-Neutral Payments
The House has passed legislation containing site-neutral provisions, and the Senate is exploring legislative action on this issue. Your outpatient departments play a fundamental role in ensuring access to care for the communities you serve. These policies are not neutral — they are a cut to essential hospitals.
Essential Health System Designation
This Congress saw the introduction of the bipartisan Reinforcing Essential Health Systems for Communities Act (H.R. 7397) by Reps. Lori Trahan (D-Mass.) and David Valadao (R-Calif.). The bill, which resulted from advocacy by America’s Essential Hospitals and its members, would define and support essential hospitals across the country. An end-of-year package would be the best vehicle to get this bill across the finish line. We urge you to bring it to the attention of your members of Congress and ask them to support and cosponsor this vital legislation.
Telehealth/Hospital at Home
During the COVID-19 public health emergency, the federal government expanded access to telehealth services for Medicare patients. Congress subsequently extended access to key services through December 2024, and there have been multiple efforts in both chambers to extend Medicare patients’ access to telehealth services beyond this date. There also has been bipartisan support in both chambers to extend the Acute Hospital Care at Home waiver program. This innovative initiative has become a valuable and reliable solution for delivering high-quality and effective care to patients in the comfort and security of their homes, particularly during and after the challenging pandemic. As we approach an end-of-year package that overlaps with the expiration of these programs and services, it is important to let your delegation know how your hospital uses these services to care for their constituents.
For questions or concerns, contact Jason Pray, vice president of legislative affairs, at jpray@essentialhospitals.org.