July 26, 2021
The Honorable Charles E. Schumer The Honorable Mitch McConnell
Majority Leader Republican Leader
U.S. Senate U.S. Senate
Washington, DC 20510 Washington, DC 20510
Dear Leader Schumer and Leader McConnell:
On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) writes to strongly oppose any attempt to take away previously-appropriated funding for hospitals and health systems, physicians, nurses and other health care providers providing heroic care during a global pandemic. It would be short-sighted of Congress, the White House and the Department of Health and Human Services (HHS) to take funding away from hospitals, health systems and other health providers while COVID-19 cases, hospitalizations and deaths are surging again throughout the nation.
The COVID-19 public health emergency (PHE) is very much ongoing. COVID-19 cases and hospitalizations are once again increasing in many areas of the country. For example, for the week ending July 20, hospitalizations in 42 states increased week-over-week, with 15 states increasing by 40% or more (see attached table). Similarly, COVID-19 cases have increased dramatically across the country, with 28 states experiencing a 50% or more increase week-over-week. Many areas of the country are experiencing high intensive care unit (ICU) bed occupancy rates, with 12 states over 75%. Further, experts continue to warn that the more contagious delta variant combined with lower vaccination rates in certain areas of the country could spur a fall and winter surge in COVID-19 cases.
In addition, despite the ongoing pandemic and evidence provided about the continued need for additional funding, the Administration has yet to distribute remaining PRF amounts. The Health Resources and Services Administration (HRSA) made PRF distributions to health care providers throughout 2020. For example, in April 2020, it made Phase 1 and 2 General Distributions. In May 2020, it made payments to providers serving COVID-19 hot-spot areas, as well as those serving rural areas. In June 2020, it provided funds to hospitals serving high numbers of Medicaid and uninsured patients. July 2020, HRSA made additional distributions to hot spot and rural providers, and in August 2020, to those that had not received proportionate General Distribution funds, as well as to children's hospitals. Finally, in December 2020, funds provided through the Phase 3 application process began going out.
The simple fact is that distributions have not kept pace with the pandemic, despite the existence of funding provided by Congress. Except for distributions from Phases 1 and 2, most distributions have been based on metrics from the first half of 2020 – a timeframe from more than a year ago. Many hospitals and health systems had significant costs during COVID-19 surges last summer and winter, and they have needs now. However, they have not received funding targeted to those timeframes, despite the availability of that funding. That is unacceptable.
The Phase 3 distribution that began in December 2020 was the last funding distribution announced and made by HRSA. This is despite the fact that, as reported by the Government Accountability Office, about 25% of PRF funds ($43.7 billion of $178 billion) still have not been distributed. In addition, HRSA has not announced any plans to distribute the $8.5 billion in relief funds appropriated under the American Rescue Plan Act for rural providers.
We urge Congress to oppose any provisions that would rescind funding from the PRF to pay for spending unrelated to the COVID-19 pandemic, and we would oppose any infrastructure legislation that contains these provisions. Failing to do so denies the seriousness of the current state of the COVID-19 pandemic and the work that hospitals and health systems, physicians, nurses and other health care providers are doing to care for patients and communities.
Thank you for your consideration.
Richard J. Pollack
President and Chief Executive Officer