Communications

(March 14, 2025) – Last week, I had the opportunity to travel to Washington, DC, with representatives from Kansas hospitals as part of the American Hospital Association's Advocacy Day to visit our members of Congress on Capitol Hill to discuss our federal priorities. We had the opportunity to meet with Congressman Tracey Mann, Congressman Derek Schmidt and Congresswoman Sharice Davids and staff for Senator Jerry Moran and Congressman Ron Estes. While there have been substantial changes related to the turnover in power to the Donald Trump Administration and complete Republican control of Congress, our message to our representatives and senators has remained remarkably consistent: ensure stable programmatic Medicare and Medicaid funding and protect the future of the 340B Drug Pricing Program.

This consistency has paid off as the first major bill of the 119th Congress – the fiscal year 2025 Continuing Resolution, the bill that will fund the federal government for the duration of the current fiscal year – protects telehealth access, Medicare's low-volume adjustment, the Medicare dependent hospital program, and –importantly for Kansas – further delay in the Affordable Care Act's disproportionate share hospital cuts. While this bill does not extend the so-called "doc fix" or the ACA's enhanced premium tax credits, earlier iterations of the CR were rumored to include some of these items potentially. Our work with our federal elected officials over the years to help them understand these complex issues and AHA's excellent timing for a large lobbying day certainly paid off!

The House passed its version of the CR on Tuesday night by a slim 217-213 margin, with one Republican voting no and one Democrat voting aye. Regardless of how things go from here, the more conservative chamber has passed the bill it deemed the most conservative it could pass, and these important health care extenders were included. Whatever ultimately passes will include them, even if we have to endure a government shutdown.

The next major agenda item on the horizon is the budget reconciliation bill, which must address the expiration of the Trump I-era tax cuts. To pass this bill, Congress must adopt a new budget resolution that sets the reconciliation bill's spending and revenue targets. The House and Senate are in conference to unify their vastly different budget resolutions. Of particular concern for the health care community, the House's version of the budget resolution instructs the House Energy and Commerce Committee to find $880 million in cuts over ten years. If they do not touch Medicare, they must cut Medicaid to some extent to meet this mandate. We oppose widespread Medicaid reductions and have made this clear to our delegation. Expect this to be a point of contention on the reconciliation bill going forward.

Finally, we are working with our delegation on a proposal to help hospitals retain their 340B eligibility despite Medicaid waiver changes at the state level. With Kansas's adoption of a Sec. 1915 Medicaid waiver, some hospitals are dangerously close to the 340B eligibility line because their cost reports do not allow them to count uninsured, uncompensated care in their eligibility calculation. We are exploring options to address this with an upcoming budget or spending bill provision.

As always, we encourage your participation in KHA's advocacy efforts on the federal and state levels. Please don't hesitate to contact the KHA staff if you need assistance!
--Chad Austin