Continuing the Fight to Protect Medicaid and Access to 24/7 Hospital Care for Patients and Communities

Three key House committees — Energy and Commerce, Ways and Means, and Agriculture — after long debates and discussions this week advanced their portions of a massive reconciliation bill aimed at realizing President Trump’s legislative agenda.

The Energy and Commerce Committee, which was instructed to reduce deficits by $880 billion, approved widespread changes to the Medicaid program that, if enacted, would be a devastating blow to the health and well-being of our nation’s most vulnerable citizens and communities.

Many of the policies will not make the Medicaid program work better for the 72 million Americans who rely on it. They include babies and children, people with disabilities, the elderly, and nursing home patients. They also are many hard-working people, including farmers, ranchers, veterans and single moms. In fact, these policies will result in displacing millions of Americans from insured status to uninsured, putting their health and financial stability at serious risk.

There is no avoiding the real-life consequences these proposals will create for hospitals’ and health systems’ ability to deliver 24/7 care and services to all patients across the country, not just Medicaid beneficiaries. Some hospitals, especially those in rural or underserved communities, could be forced to close. Many others would have to significantly reduce services. Other impacts could be longer waiting times to receive care, more crowded emergency departments, and hospitals not being able to invest in technology and advancements for clinical care.

Earlier this week, we sent a statement to the Energy and Commerce Committee detailing our position on several provisions included in the legislative package. Specifically, we expressed our concerns that the bill restrains and diminishes provider taxes and state directed payment programs that are vital to the financial stability of hospitals and health systems and help them deliver essential services to Medicaid beneficiaries, since Medicaid historically and chronically underpays for the cost of caring for the millions of Americans that rely on the program.  

Some politicians and other stakeholders have mislabeled these programs and financing mechanisms as “waste, fraud and abuse.” They are nothing of the sort. The truth is the proposed changes to these programs are not real reform.

Most states likely would be unable to close the financing gap created by further limiting their ability to tax providers; as a result, they may need to make significant cuts to their Medicaid programs, including reducing eligibility, eliminating or limiting benefits, and further reducing the chronic Medicaid underpayment rates for providers. In addition, states could address financial losses by limiting or eliminating nonmandatory benefits for all Medicaid beneficiaries, such as prescription drug coverage, clinic services, certain behavioral health services, home and community-based services, and physical and occupational therapy.

While the legislation advanced out of committee, it still has a long way to go before crossing the finish line. The full House of Representatives could consider the package as soon as next week. And in the Senate — where some Republicans have already expressed concern about various House proposals — there would likely be changes to the bill should it pass the House.

That means that we still have opportunities to influence the debate and the final package. We will continue to work with lawmakers to help them understand the impact these reductions will have on patients and the hospitals that care for them and their communities. Meanwhile, the Coalition to Strengthen America’s Healthcare, of which the AHA is a founding member, continues to run TV and digital advertisements targeted to key stakeholders. This week, the Coalition launched its newest ad in its Faces of Medicaid campaign, telling the story of a family navigating the threat of limited health care options if Congress decides to make cuts to Medicaid.

We appreciate your efforts already in sharing with your lawmakers the negative consequences some of the proposals would have on the patients and communities you serve. It’s more important than ever to continue to share those stories as every vote in the House and Senate matters with slim majorities in both chambers of Congress. And visit AHA’s Action Center webpage for the latest resources to assist your efforts.

Tomorrow wraps up National Hospital Week. Throughout the week, we have been amplifying stories about the amazing work the women and men of America’s hospitals and health systems do every day to care for patients and support communities. Please take 30 seconds to watch this video posted on our National Hospital Week page that shares some of this incredible and inspiring work.

One simple line from the video says, “People count on us.” That’s a powerful message. And it’s one lawmakers need to hear again and again as they consider changes that could affect hospitals’ ability to provide 24/7 care and services to people and communities across the country.