Communications

(Nov. 1, 2024) – I have no doubts that you are geared up to vote next week or have already cast your ballot in the 2024 general election. Seeing so many members talking about voting and using resources in the We Care We Vote Campaign toolkit has been encouraging. But it is also important to remember that regardless of the election fervor currently sweeping the country or the results on Nov. 5, Congress will return to D.C. the next week with much to complete before the end of the year.

Notably, Congress must reach some kind of budget deal by Dec. 20. As you might expect, how the lame-duck session plays out will have much to do with the election results. Any significant power shift – former President Donald Trump winning the presidency or either party gaining control of both chambers of Congress – would likely mean a continuing resolution to keep the federal budget stable at fiscal year 2024 levels and kick major budget decisions to the new president and incoming 119th Congress. A victory by Vice President Kamala Harris and split control of the 119th Congress may create a scramble to pass a full-year omnibus budget bill to create new spending baselines for 2025.

Regardless of the election outcomes, our priorities for the Congressional lame-duck session are clear: do no harm to hospitals' budgets, keep current programs in place and do not extend sequestration as a revenue mechanism. Below are some key priorities and messages that will continue to be shared with the Kansas Congressional Delegation.

• No 4 percent pay-as-you-go sequestration cut should be enacted to "pay" for keeping hospitals open during the COVID pandemic. Congress must act year-to-year to waive this budgetary haymaker because they didn't permanently waive PAYGO for the pandemic-era sequestration holiday.
• No disproportionate share hospital cuts to non-Medicaid expansion states should be enacted. Such cuts would hurt hospitals already burdened financially by providing necessary care to many uninsured individuals.
• No use of Medicare site-neutral payment schemes as budgetary pay-fors. These make no sense since hospitals, unlike clinics, must operate under rigorous Emergency Medical Treatment and Labor Act standards.
• Permanently adopt the Medicare Dependent Hospital and Low-Volume Hospital programs at current levels. Without statutory change, MDH will expire and LVH eligibility will become far more restrictive.
• Permanently adopt telehealth waivers present in current law. Many of these will expire at the end of the year without congressional action.
• Extend the hospital-at-home program for another five years. This program is set to expire on Dec. 31.
• No sequestration extension as a pay-for. Extending sequestration beyond its 2032 end date is a budgetary gimmick that allows Medicare to pay for only 99 percent of its expenses instead of 100 percent.

Rest assured, our congressional delegation is aware of these priorities, and we look forward to working with them to make them a reality in the lame-duck session and beyond! Thanks again for your continued involvement in KHA's advocacy efforts! And thank you for your efforts to get the vote out and by voting yourself on Nov. 5 if you haven’t already cast your ballot.
--Chad Austin