Much at Stake as Congress Completes Work for the Year

Health care has been the top issue in Congress all year, and December is shaping up to be no different. The tax reform bills working their way through Congress could mean major changes for America’s hospitals and health systems.

Because each house will likely pass different versions of tax reform, they must now reconcile the bills for final passage. We’re pleased that the Senate bill does not eliminate the tax-exemption for private-activity bonds, protecting hospitals’ and health systems’ access to this vital source of low-cost capital.

We’re extremely disappointed, however, that the Senate bill includes a provision to repeal the individual mandate for health coverage, which could result in loss of coverage and increase premiums in the nongroup health insurance market by 10%.

Some proponents of repealing the mandate say that passing additional legislation designed to bring stability to the health insurance marketplaces, including by funding the cost-sharing reductions and implementing a reinsurance program, will be enough to protect coverage. These provisions, while beneficial, were built on the premise that the individual mandate, which broadens the risk pool, was in place. Loss of the individual mandate would weaken the impact of CSR funding and reinsurance.

Any reforms to the health care system must protect coverage and access to care, especially for our most vulnerable – including the poor, the disabled, children and the elderly. Repeal of the individual mandate fails that test. We’ll continue to fight for our patients and communities as Congress shapes the final tax bill. Please contact your legislators and urge them to protect coverage.

As tax reform moves forward, Congress also has a long to-do list that includes many other issues critical to hospitals and health systems. We’re actively engaged in advocating for our members on several fronts, including funding for the Children’s Health Insurance Program, the extension of several Medicare programs critical to rural hospitals, the delay of Medicaid cuts to disproportionate share hospitals and restoring funding to the 340B drug savings program.

Congress could address these issues through a number of legislative vehicles that must pass before year’s end, including funding bills to keep the government open. We’ll keep you informed and up to date as the endgame on Capitol Hill draws to a close.