DSH, Telehealth, Hospital at Home Advocacy Continues After Government Shutdown Ends
Congress finally emerged from its historic shutdown on Nov. 12, without resolving several key issues—most notably, the looming expiration of Affordable Care Act (ACA) premium tax credits on Jan. 1 that was the sticking point of the shutdown. Lawmakers also made minimal progress on funding most of the federal government beyond the current continuing resolution (CR), which will expire at the end of January.
Our advocacy in this space remains focused on protecting critical health care “extenders.” While the CR temporarily delays Medicaid disproportionate share hospital (DSH) cuts until the end of January, we continue to urge Congress to eliminate these cuts permanently. With federal spending under heightened scrutiny—particularly within Medicaid—America’s Essential Hospitals emphasizes that Medicaid DSH funding is indispensable.
In September, more than 250 member hospitals signed an association-led letter urging Congress to prevent the $8 billion Medicaid DSH cut that would have taken effect Oct. 1 absent action. That same month, we joined a coalition of health care organizations in urging congressional leaders to address these pending reductions.
Congress also must extend Medicare telehealth flexibilities and the Acute Hospital Care at Home program. While the CR provides short-term relief on these provisions, we will continue advocating for long-term extensions.
340B Drug Pricing Program
Despite the shutdown, 340B remained a consistent issue on Capitol Hill, including during an Oct. 23 Senate Committee on Health, Education, Labor, and Pensions hearing. While much of the discussion centered on program growth and possible reforms, we saw encouraging moments of bipartisan support for the program. Several members questioned whether significant changes to 340B are feasible given the passage of H.R. 1 and the potential expiration of ACA tax credits. Notably, Sen. Tommy Tuberville (R-Ala.) suggested expanding the program, referencing charity care provided by association member East Alabama Health. Sen. John Hickenlooper (D-Colo.) highlighted data from association member Denver Health, underscoring the system’s high share of uninsured and underinsured patients. These examples helped illustrate the community impact of our member hospitals.
Ahead of and following the hearing, the association actively engaged congressional offices, providing education and widely sharing its statement for the record.
On the House side, we are aware that a companion group to the Senate “Gang of Six,” which is a bipartisan working group focused on the strength of the program, may be emerging. We are also monitoring reports of a more pharmaceutical-friendly iteration of the 118th Congress’ SUSTAIN Act. We continue to meet with offices to explain the vital importance of the 340B program to essential hospitals and to voice our strong support for maintaining the program as is.
Designation
We are continuing to work with bipartisan champions in the House to reintroduce the Reinforcing Essential Health Systems for Communities Act, which was first introduced in the 118th Congress by Reps. Lori Trahan (D-Mass.) and David Valadao (R-Calif.). The bill would create the first-ever federal definition of “essential health systems,” giving Congress a clear tool to support and protect the nation’s foundational safety net providers. Discussions are also underway to introduce companion legislation in the Senate. Once introduced, we encourage FAN members to engage their delegations to cosponsor and champion this critical legislation.
Medicare Cuts to Hospitals
The association also continues to push back against harmful Medicare cuts to hospitals (aka “site-neutral” payments). These proposals, which Congress has eyed to offset other health care priorities in the past, remain a threat in the 119th Congress. These policies would constitute a cut to essential hospitals and Medicare writ large, and we are educating lawmakers about why they would negatively impact health care access.
If you have questions about our ongoing advocacy, do not hesitate to contact our team directly.