September 8, 2021

Friends in high places: it certainly doesn’t hurt; and, more often than not, that advantage can greatly help. Having the right connections can make all the difference in pushing your agenda through and realizing ultimate success. There is perhaps no greater example of this than those who roam the corridors of power in Washington, D.C.—not the legislators themselves, but those who influence them.

Senators and U.S. representatives cannot come up with everything on their own. They have a staff and a team of legal experts who help craft and review legislation. But that’s not all they have. They depend, in large measure, on advice and counsel coming from those who are experts in a particular field. In other words, they give ear to lobbyists, often allowing such individuals to help write provisions that become law. It is with this dynamic in mind, that we provide you with today’s article.

A Massive Infusion of Funds

The Washington Post is reporting that the administration’s $3.5 trillion economic agenda—known as the budget reconciliation bill—is set to resume consideration on Capitol Hill this week. What is shaping up to be the largest spending package in U.S. history includes provisions that will address the healthcare industry.

Congressional Democrats are working to include the following provisions in the bill:

Lower the Medicare eligibility age from 65 to 60

Expand Medicare to cover dental, vision and hearing benefits

Grant the government new powers to negotiate drug costs with the goal of lowering what seniors would have to pay
However, one of the Democrats’ own, U.S. Senator Joe Manchin of West Virginia, has already expressed opposition to lowering the Medicare age, as well as concerns over the overall cost of the bill. With the Senate in a precarious 50-50 balance between the political parties, and the Democratic vice president acting as the tie-breaker, losing the support of this one Democrat may imperil the entire package.

Enter the Influencers

The American Hospital Association (AHA) is a powerful force in our nation’s capital. It has the ear of our national legislators. As such, what it says carries weight. Knowing that the bill, in its current form, may not survive, the AHA nevertheless generated a letter to Congress late last week, requesting the legislative branch to consider the inclusion of several components within the bill—regardless of its final form and price tag—that the AHA maintains is vital to America’s hospitals. In its letter, the AHA requested that Congress use the budget reconciliation package to address some of the organization’s top priorities, such as the following:

Workforce Measures. Understanding the projections of future shortages in healthcare workers and doctors, the AHA has asked Congress to use the massive funding bill to increase the number medical schools. In addition, it has requested that there be a lifting of the cap on the number of residencies that can be funded by Medicare. The AHA letter also expressed a desire to see an expansion of nursing schools, as well as a relaxation of visa restrictions on foreign-born nurses. Finally, The AHA suggested that the budget reconciliation funds be used to address the current epidemic of burnout among healthcare workers.

Mental Health. The AHA’s letter requested Congress to provide greater funding relative to mental health issues. As part of this request, the AHA proposed that the legislative package include the addition of 1,000 training positions in approved residency programs that pertain to addiction medicine, addiction psychiatry and pain medicine. These positions would be funded by the Medicare program. The AHA also expressed its support for repealing the Institutions for Mental Disease (IMD) exclusion.

Healthcare Coverage. In its letter to Congress, the AHA requested the following provisions to be included withing the budget reconciliation bill:

Extending rules to reduce the cost of marketplace coverage for all subsidy-eligible individuals and families and to expand eligibility for tax credit subsidies to more individuals.

Providing health care coverage to individuals in states that did not expand Medicaid after expansion of the Affordable Care Act.
Prescription Drug Pricing. The AHA indicated its desire for Congress to provide temporary relief for any hospital participating in the 340B Drug Pricing Program that had to leave the program due to the COVID-19 pandemic.

Telehealth and Cybersecurity. The AHA urged Congress to prioritize investment in telehealth and cybersecurity so that all patients have secure, sustained, and equitable access to care using digital and information technologies. This includes a request to:

Provide funding for the Federal Communications Commission’s (FCC) Rural Health Care Program, with specific funding to increase the program subsidy and offset the high upfront costs of “last mile” broadband connections for rural hospitals.

Expand the FCC COVID-19 Telehealth Program to provide offsets for hospitals’ telehealth infrastructure costs, including those related to telecommunications services, information services and devices.

Remove Medicare’s limitations on telehealth and appropriately reimbursing hospitals and health systems for providing telehealth services.

Eliminate originating and geographic site requirements.

Expand the types of technology that can be used for furnishing telehealth services, including audio-only connections, and allow hospitals to bill for virtual care they provide.
To read the full set of AHA proposals sent to Congress in connection with the budget reconciliation measure, you can go to the following link: AHA Letter to House and Senate Sharing Priorities in Upcoming Budget Reconciliation Legislation | AHA. If you have a question about how we at MiraMed Global Services can assist you with your business needs, you can reach us at info@miramedgs.com.