News Releases

The Center for Health Affairs Advocates for Hospitals and Patients as Congress Finalizes End-of-Year Legislation

The Center for Health Affairs is advocating for several healthcare policies that provide vital services to patients, protections to workers, and funding to hospitals, before the end, on Dec. 20, of the continuing resolution (CR) currently funding the federal government.  As hospitals continue to face issues related to workforce shortages, inflation and rising costs, cyberattacks, regulatory barriers, and more, Congress has an opportunity to pass legislation to address these concerns.

The Center is currently advocating for the following priorities:

Telehealth

Providing improved access to care for patients across the United States — including individuals in rural areas, people with mobility issues, and patients in need of a specialist not located in their area — the use of telehealth increased significantly during the COVID-19 pandemic.

While some pandemic-related telehealth waivers were made permanent, several are set to expire at the end of the year. The Center is advocating for the permanent adoption of waivers that allow audio-only telehealth services and that eliminate restrictions on where a telehealth patient can be located as well as in-person requirements for tele-behavioral health. There appears to be broad support for the inclusion of these extenders in the lame duck package.

Hospital-at-Home

Launched by the Centers for Medicare & Medicaid Services during the COVID-19 pandemic, the hospital-at-home program brings acute-level hospital care directly to a patient’s residence. Set to expire at the end of 2024, the Hospital Inpatient Services Modernization Act (H.R. 8260/S. 4350) calls for extending the hospital-at-home waiver through 2029.

According to the American Hospital Association, as of June 2024, 331 hospitals across 136 systems and 37 states have been approved to provide hospital-at-home services to patients. The Center is supporting the extension and is advocating for its inclusion in Congress’ end-of-year legislative package.

Medicaid Disproportionate Share Hospital Cuts

The Center supports protecting Medicaid Disproportionate Share Hospital (DSH) funding. This critical funding helps hospitals that treat the most vulnerable patients in their communities. While Medicaid DSH does not always fully cover the cost of uncompensated care, these payments help hospitals continue to serve low-income and uninsured patients.

Currently, Medicaid only pays 87 cents for every dollar of hospital care provided. Unless Congress acts, a funding cut is scheduled to go into effect that would reduce Medicaid DSH funding by $8 billion. The Center urged our local members of Congress to support a recent letter to leadership asking that relief from these pending cuts be included in the end-of-year package. We are grateful for the support of Reps. Shontel Brown, Dave Joyce, Max Miller, and Emilia Sykes. The Center’s conversations with offices on the Hill this week indicated optimism about the inclusion of DSH cut relief in an end-of-year package.

Site Neutral Payments

While hospitals are increasingly more expensive to operate, unfortunately, they are only reimbursed 82 cents for every dollar of care provided to Medicare patients. If site-neutral policies are implemented, hospitals face even more substantial losses. In Northeast Ohio, hospitals lost more than $257 million on Medicare services in 2022.

The Center is asking Congress to reject site-neutral payment policies, which require Medicare to reimburse for procedures and services at the same rate, regardless of whether they are provided in a hospital doctor’s office, imaging center, or clinic.

340B Drug Program

The Center is advocating for the protection of the 340B Drug Pricing Program. The program was initially created by Congress in 1992 as part of a bipartisan effort to protect hospitals and patients from the growing problem of rising drug costs.

The program allows hospitals caring for large numbers of underserved patients to stretch scarce federal resources and provide more comprehensive care by requiring drug companies to offer discounted prices on certain outpatient drugs. There is currently a significant amount of litigation challenging this program and pharmaceutical companies are seeking alternative payment arrangements that would limit these discounts and hinder hospitals’ ability to provide needed treatments to patients.

SAVE Act

The Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768) would protect hospital and healthcare workers from violence and intimidation in their workplaces. This bipartisan bill would provide the protections similar to those that exist for flight crews, flight attendants and airport workers. Despite the sharp increase in physical and verbal abuse seen by healthcare workers in recent years, no federal law protects healthcare employees from workplace assault or intimidation.

Based on conversations that The Center’s policy team had this week in Washington, DC, it appears that this legislation will be reintroduced in the new Congress.

Workforce Shortages

Hospitals and other healthcare providers are continuing to experience shortages of workers, including nurses, physicians, respiratory therapists, behavioral health professionals and more. The Center has shared with the Northeast Ohio Congressional delegation its support for the following three bills.

1. The Healthcare Resiliency Act (H.R. 6205/S 3211) would recapture 25,000 unused employment-based visas for foreign-born nurses and 15,000 for foreign-born physicians.
2. The Conrad State 30 and Physician Access Reauthorization Act (H.R. 4942/S. 665) would reauthorize a long-standing program that has incentivized approximately 20,000 foreign medical graduates to practice medicine in rural and underserved areas.
3. The Dr. Lorna Breen Health Care Provider Protection Act (H.R. 7153/S. 3679) would provide grants to help healthcare organizations offer behavioral health services for front-line healthcare workers through 2029. 

It appears these bills will likely be reintroduced in the 119^th session. With the new Administration's anticipated immigration agenda, The Center will continue to support the use of employment-based visas to help fill health provider vacancies.

As the Dec. 20 deadline approaches, Congress is expected to pass another short-term CR to extend federal funding into next year, possibly just until March 2025. This would effectively delay major budget decisions until the Republicans’ trifecta in 2025 when they will control the House, Senate and White House.

The Center for Health Affairs amplifies the voice of Northeast Ohio healthcare institutions to protect access to quality care and services for the communities we serve and will continue to advocate on behalf of hospitals and other providers of care to support the above legislation.

To learn more on these efforts, listen to the first in The Center’s new Policy Points video series providing timely updates on advocacy initiatives.