Our Advocacy Achievements

Protecting Medicaid

America’s Essential Hospitals strongly advocated against Medicaid cuts in the Working Families Tax Cut legislation (WFTCL). Though the legislation passed into law, the association succeeded in preventing changes to federal medical assistance percentage rates and per capita caps.

We continue to emphasize the devastating impact that the WFTCL measures will have on low-income communities and the essential hospitals that serve them. As the Centers for Medicare & Medicaid Services (CMS) begins to implement the WFTCL, the association is advocating for policies to minimize the effects of cuts on essential hospitals. In response to our comments, CMS recently extended the period during which existing state directed payments (SDPs) can be grandfathered at higher payment rates.

The association will continue to work with policymakers to minimize the impact of Medicaid cuts on our members by engaging directly with policymakers, issuing public statements, and mobilizing advocacy campaigns.

Protecting the 340B Program

Over the past year, we have reinforced on Capitol Hill that the 340B Drug Pricing Program is working as Congress intended, allowing essential hospitals to stretch scarce resources and expand access to care. We elevated that message during pivotal moments, including through a statement on the October 2025 hearing before the Senate Committee on Health, Education, Labor and Pensions focused on potential programmatic reforms.

America’s Essential Hospitals has continued to defend the 340B Drug Pricing Program against manufacturer attempts to undermine the program. The association joined legal action to block the implementation of costly and illegal rebate pilots proposed by the Health Resources and Services Administration (HRSA). A federal district court prohibited the rebate pilot from taking effect as scheduled on Jan. 1, 2026, although HRSA continues to consider implementing a rebate pilot program. We frequently dialogue with HRSA leadership to share our hospitals’ concerns about manufacturer actions.

Averting Medicaid DSH Cuts

With broad bipartisan support in Congress, America’s Essential Hospitals eliminated two years of cuts to Medicaid disproportionate share hospital (DSH) funding in fiscal years (FYs) 2026 and 2027. These victories are the latest in a decade of wins to eliminate or delay DSH cuts. The association now is working with lawmakers to eliminate the remaining $8 billion in cuts for FY 2028.

Defining Essential Hospitals in Law

The association advocated for the reintroduction of the Reinforcing Essential Health Systems for Communities Act (H.R. 7145), bipartisan legislation that would establish an “essential health system” designation in federal law. The designation bill, which gained cosponsors after its introduction, would give policymakers a powerful tool to target essential hospitals with policy protections, funding, and incentives to support their safety net role.

Stopping Site-Neutral Payment Cuts

America’s Essential Hospitals has prioritized stopping misguided attempts to put Medicare hospital payments for outpatient services on par with those for physician offices. These so-called “site-neutral” policies amount to nothing more than hospital cuts. Although CMS has expanded site-neutral payment cuts to drug administration via regulation, the association has helped stop legislation that would have implemented cuts to other essential services.

Extending Telehealth and Hospital-at-Home Programs

America’s Essential Hospitals played a pivotal role in advocating Congress to extend Medicare telehealth flexibilities. By highlighting the significant benefits of telehealth, especially for underserved communities, we emphasized how these services increase access to care and improve patient outcomes. In February 2026, Congress extended Medicare telehealth program flexibilities through Dec. 31, 2027.

We also worked successfully with Congress to extend the Acute Hospital Care at Home waiver through Sept. 30, 2030, stabilizing the program. More than 380 hospitals across 39 states currently employ this program. They provide inpatient-level care in patients’ homes, improving patient satisfaction and reducing complications like falls and readmissions. We will continue our advocacy to make both telehealth flexibilities and the hospital-at-home programs permanent to enhance access to care and target factors outside hospital walls that influence health.

Supporting Member Innovation in AI

The association has helped position essential hospitals as leaders in utilizing emerging technologies to increase efficiency and improve patient outcomes. The association recently provided feedback to the Department of Health and Human Services (HHS) on ways to ensure that AI tools consider the unique challenges that our hospitals and their patients face, and the association has started a new AI Interest Group to inform our continued engagement on AI policy. We continue to advocate that HHS install appropriate regulations around AI and invest in essential hospitals’ ability to adopt these technologies.

Including Essential Hospitals in Rural Health Policy

As policymakers consider changes to support rural health care access, the association is working to make sure that our members are part of the solution. Building on prior efforts to highlight the role of essential hospitals in rural communities, the association has supported members who have applied for rural health transformation funding. In meetings with CMS leadership, we have discussed new ways to pay essential hospitals for their work to support rural providers, even if they are not physically located in a rural area.

Raising the Visibility of Essential Hospitals

Policymakers and the media turn to America’s Essential Hospitals as the nation’s foremost voice on Medicaid, the 340B program, and other issues important to hospitals that care for underserved communities. Through regular national and trade media coverage, we tell the story of our members and the communities they serve. We also raise our members’ visibility in Washington, D.C., through the Essential Hospitals Political Action Committee, Federal Action Network, Federal Advocacy Assembly, and Government Relations Academy.

In early November the association published Essential Data 2025, an annual snapshot of our members and the people and communities they serve. We found that essential hospitals provided $8.6 billion in charity care, or 29% of all charity care in the United States, despite representing only 6% of hospitals nationwide. We utilize data and graphics from Essential Data to continue to support member advocacy efforts at the state and federal level.