Hospitals press Congress for help as shutdown looms

Hospitals are calling on Congress to preserve key health programs as another budget deadline looms.

In what has become a recurring theme, lawmakers are facing a pressing deadline as another short-term spending plan is poised to expire on Sept. 30. Hospitals and other healthcare groups are pressing Congress to preserve key programs and tackle a host of their priorities.

Health care is shaping up to be at the center of the spending fight. Senate Democratic Leader Chuck Schumer and House Democratic Leader Hakeem Jeffries have said any spending package must include concessions on health programs, including tax credits supporting the Affordable Care Act.

The American Hospital Association sent a letter Monday to Republican and Democratic leaders in Congress outlining their priorities.

Telehealth programs stand near the top of the list of concerns.

Congress approved a short-term extension of approvals for telehealth programs, including hospital-at-home programs, in the last short-term spending bill. Those approvals are slated to expire Sept. 30.

“Telehealth provides a tremendous ability to leverage geographically dispersed provider capacity to support patient demand. Congress should permanently adopt telehealth waivers and expand the telehealth workforce,” the hospital association wrote.

Kyle Zebley, senior vice president of public policy at the American Telemedicine Association, told Chief Healthcare Executive in July that he expects Congress to offer another extension for telehealth, although it could be another temporary measure. Still, he touts strong bipartisan support for telehealth programs.

“I remain very optimistic, and very much expect a high degree of certainty that it will be extended again. There’s essentially universal support on Capitol Hill,” Zebley said in July.

Hospitals are also worried about the pending reductions for a Medicaid program that offers additional funding for hospitals with a high percentage of Medicaid patients. The Medicaid Disproportionate Share Hospital program is slated to be cut by $8 billion on Oct. 1.

Congress has averted similar cuts to the Medicaid program in the past, and hospitals are hoping that lawmakers will step up again.

“The Medicaid DSH program provides essential financial assistance to hospitals that care for our nation’s most vulnerable populations — children and people who are impoverished, disabled or elderly,” the hospital association wrote in the letter to lawmakers.

Hospitals are also hoping to prevent the elimination of two Medicare programs supporting rural hospitals: the Medicare-dependent Hospitals and Low-volume Adjustment programs. Without congressional action, the programs are slated to expire on Sept. 30.

The Medicare-dependent Hospital program offers more aid to smaller hospitals with a large share of Medicare patients. It supports more than 170 hospitals.

Conversely, Medicare’s Low-Volume Hospital program supports rural hospitals with a smaller number of Medicare patients. That program supports more than 600 hospitals.

Hospitals are anxious to preserve enhanced tax credits that support the Affordable Care Act. Millions of Americans could lose coverage if the tax credits expire, and they are slated to disappear at the end of the year.

The tax credits help those who can’t get affordable insurance through an employer and don’t have access to a government program.

Chip Kahn, president and CEO of the Federation of American Hospitals, has been urging Congress to ensure the continuation of those tax credits. He made the case in a blog he wrote Aug. 27.

“Without question extending the enhanced premium tax credits is a critical path to ensuring access to affordable health coverage for millions,” Kahn wrote. “If these tax credits were to lapse, premiums could double for families across the country, they won’t be able to afford coverage, and millions of hardworking men, women, and kids will lose the peace of mind that health insurance provides for the many “what ifs” life could throw their way.”

If more people lose coverage, hospitals are going to face more financial pressures as they are forced to provide care for more people who have no ability to pay.

Schumer has said he and other top Democrats are willing to risk a government shutdown if Republicans don’t make some agreements regarding health care, including extending the tax credits for the Affordable Care Act, The Washington Post reports.

Democrats say they’re especially determined after the Republican-led Congress approved cuts to Medicaid in the tax package President Trump signed in July.

The House has introduced a spending measure that would fund the government through Nov. 21, but it doesn't include the extended tax credits for the Affordable Care Act.

In a news release Tuesday, Kahn said in a statement, "As time runs out on health care tax credits, sticker shock awaits working families."

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