By – Funding legislation aimed at keeping HHS and other non-Defense agencies running in fiscal year (FY) 2020 will also postpone $4 billion in Medicaid Disproportionate Share Hospital (DSH) payment cuts until May 20, 2020.
In a 71-23 vote yesterday, the Senate sent the legislation (H.R. 1865) to the president for his signature before the current funding expires later tonight. The House approved the Medicaid DSH payment reduction delay on Tuesday in a 297-120 vote, giving safety-net hospitals another win.
Policymakers are to reduce the payments to safety-net hospitals under the authority of the Affordable Care Act (ACA). The law from 2010 directs policymakers to decrease the payments in response to higher insured rates from healthcare insurance reforms enacted under the law. The cuts were scheduled to take effect in 2014, but Congress decided to delay implementation several times since then, with the most recent delay pushing the implementation date to Oct. 1, 2020.
Hospitals have staunchly opposed the reductions to the payments, which are meant to offset the financial losses hospitals treating a significantly higher portion of low-income patients incur. Industry groups representing the hospitals have argued that health insurance reforms have not made the gains expected under the ACA, resulting in little change in uncompensated care costs for hospitals.
The groups commended Congress for passing another delay of the Medicaid DSH cuts. The most recent postponement will “avert the harm sure to result from a $4 billion payment cut for hospitals that care for millions of low-income people,” according to Beth Feldpush, DrPH, senior vice president of policy and advocacy at America’s Essential Hospitals.
“With rising numbers of uninsured and profound regulatory threats to Medicaid on the horizon, Congress wisely chose to extend the DSH cut delay and fund other programs central to the nation’s health care safety net,” she added in her statement on the group’s website.
The Association of American Medical Colleges also emphasized the negative impact Medicaid DSH payment cuts could have on the healthcare system in its statement of support.
“If implemented, these cuts will threaten access to care for some of the most vulnerable patients,” David J. Skorton, MD, president and CEO of AAMC, said in the statement supporting the Medicaid DSH delay and funding extensions for other healthcare programs, including National Institutes of Health, the Title VII diversity and workforce development programs, gun violence prevention research at the Centers for Disease Control and Prevention.
However, Skorton urged Congress to now address the Medicaid DSH payment reductions that go into effect on May 22, 2020. AAMC and America’s Essential Hospitals are looking for a permanent fix for scheduled Medicaid DSH payment cuts.
“Now, we must turn to longer-term relief for essential hospitals and their patients,” Feldpush said in America’s Essential Hospital’s most recent statement. “Lawmakers already have demonstrated strong bipartisan support for repealing at least two years of Medicaid DSH cuts. We urge Congress to approve a repeal as quickly as possible and lift the cloud of uncertainty from essential hospitals and the people and communities they serve.”
While safety-net hospitals breathed a sigh of relief after this week’s funding efforts, other providers are still waiting with bated breath to see how Congress plans to address highly contentious healthcare issues like prescription drug spending and surprise medical bills.
The provider community expected Congress to include some solution for the surprise medical billing issue in the funding legislation but policymakers failed to mention the problem. Instead, they tackled other issues including:
- Repealing Affordable Care Act taxes for health insurers selling Medicare Advantage plans
- Increasing market exclusivity for more drugs, including some that treat diabetes
- Boosting Medicare payments for hospitals that perform certain stem cell transplants
- Delaying price reporting requirements for clinical laboratories