The AHA president’s letter went straight to the top, as it was specifically addressed to the speaker of the House, the minority leader of the House, the Senate majority leader and the Senate minority leader. The letter begins by reminding these legislators that the nation’s 5,000 hospitals and associated healthcare workers are experiencing unique difficulties due to several factors, including increased expenses for drugs and supplies, i.e., inflation, the mounting burden due to certain commercial health insurer denial and delay practices, as well as anemic reimbursement from Medicare and Medicaid. Mr. Pollack then asked the congressional leaders to consider certain priorities for the remainder of 2025, as outlined below.
Address the Medicaid Disproportionate Share Hospital (DSH) Payment Reductions. The Medicaid DSH program is designed to provide essential financial assistance to hospitals that care for vulnerable populations. The fiscal year (FY) 2025 Medicaid DSH payment reductions are scheduled to be implemented on October 1, 2025, when $8 billion in reductions take effect. The AHA letter urged Congress to continue to provide relief from the Medicaid DSH cuts.
Protect Rural Communities’ Access to Care. The letter asked Congress to continue the Medicare-dependent Hospitals and Low-volume Adjustment programs, which provide rural, geographically isolated and low-volume hospitals with additional financial support to ensure rural residents have access to care. These programs are set to expire on September 30, 2025.
Extend Telehealth and Hospital-at-home Waivers. During the public health emergency, Congress established a series of waivers expanding access telehealth services. These waivers are set to expire on September 30, 2025. The AHA letter of September 15 asked Congress to provide additional time to gather data on quality improvement, cost savings and patient experience, and provide much-needed stability for these innovative programs.
Extend the Enhanced Premium Tax Credits (EPTCs). These tax credits provide critical support to help millions of Americans purchase insurance on the Health Insurance Marketplaces. They are only available to people who do not have access to affordable health insurance through their employer or a government program. Without congressional action, they are set to expire at the end of this year, leaving millions of people at risk of losing access to healthcare coverage.
Reject Site-neutral Payments. The AHA’s Pollack asked the leaders of Congress to not expand site-neutral payment proposals to hospital outpatient departments (HOPDs). These policies aim to lower HOPD payments to the same rates as independent physician offices and other ambulatory sites of care, ignoring the very different level of care provided by hospitals and the needs of the patients cared for in that setting.
Protect the 340B Drug Pricing Program. The 340B program allows covered entities to reduce the price of outpatient pharmaceuticals and expand health services to the patients and communities they serve. The AHA asked Congress to protect this program from harmful changes that will undermine its value.
Protect Healthcare Workers from Violence. Pollack requested Congress to enact the Save Healthcare Workers Act (H.R. 3178/S. 1600), which is a bipartisan bill that would make it a federal crime to assault a hospital staff member on the job. This is similar to the protections in current law afforded to airport and airline workers.
Hold Commercial Health Plans Accountable. It is the position of the AHA, via the Pollack letter, that certain health plan practices (e.g., inappropriate care denials and delayed payments) threaten patient access to care. It is believed that these practices also contribute to clinician burnout and add excessive administrative costs and burdens to the healthcare system. Accordingly, Pollack urged Congress to pass the Improving Seniors’ Timely Access to Care Act (H.R. 3514/S. 1816), a bipartisan bill that is supported by more than half of the members of the House and Senate. The legislation would streamline the prior authorization process in the Medicare Advantage program by eliminating complexity and promoting uniformity to reduce the wide variation in prior authorization methods that frustrate both patients and providers.
We will not have to wait long to see if congressional leaders take up the cause of any of these AHA priorities. Congress is back in session and certain deadlines are approaching. If you care about any of the above issues, consider reaching out to your own congressional representatives.