PHOENIX — Hospitals have been under enormous pressure in recent years to keep up with the onslaught of federal health care regulations. In fact, 2016 went down as one of the busiest legislative health care periods on record, with the Department of Health and Human Services issuing 23,531 pages of rules in the past year alone, American Hospital Association Senior Associate Director of Policy Priya Bathija said during the federal update session of the AHA's Rural Health Care Leadership Conference on Tuesday.
Hospital leaders have certainly been feeling the heat, to the extent that most of the room cheered when Bathija mentioned the two-for-one repeal, a recent Trump administration order to remove two regulations for every new regulation adopted by federal agencies. This is not the only executive order the president has issued signaling some regulatory relief for hospitals in the coming year.
Bathija and AHA Senior Associate Director for Federal Relations Sarah Macchiarola were able to share updates about several AHA lobbying wins, such as changes to and refunds from the Two Midnight Rule; the draining the backlogs of appeals to inappropriate Recovery Audit Contractor program denials; and the passage of the Notice Act legislation, among others.
They also addressed the uncertain future of the Affordable Care Act.
Congress plans to move toward repealing the ACA (likely around the Easter recess) through 2017 budget reconciliation, Macchiarola said, and then it plans to push tax reform and possibly Medicaid restructuring via the fiscal year 2018 reconciliation package in the fall.
(From left: Wurth, Macchiarola, Bathija)
But, she said, “There are just a host of unknowns right now in terms of how the schedule will play out.”
Macchiarola cited disagreement between Republicans in the House, on the Hill and in the Senate over ACA replacement plans, and mentioned that the Trump administration surprised everyone after the president’s recent announcement that replacement efforts would move into 2018. “That was the first I think anyone had heard of that timing,” she said.
Whatever changes may come, the AHA is working vigorously to ensure hospitals aren’t adversely affected, Macchiarola said.
“We are very concerned at the AHA and have been doing a lot of advocacy around making sure that repeal and replace happen at the same time,” she said. “And, if it doesn’t happen at the same time, we need to make sure that cuts to hospitals are restored and that money stays in the system to be used for replace.”
Maryjane Wurth, executive vice president and chief operating officer, American Hospital Association; president and CEO, Health Forum, said that although we are entering “uncharted territory,” hospitals can still look to the AHA for guidance.
“We understand the stakes are really high,” Wurth said. “Our goal is to make sure you not only have the latest information, but as this moves along, that we understand what the impact is on all of you and how we can all work together for an optimal outcome that keeps access to needed services.”
The speakers encouraged rural trustees and CEOs to reach out to Congress with their policy and payment concerns, underscoring the importance of their voices.
“You may not feel comfortable reaching out to your members of Congress,” Macchiarola said. “But let me tell you, as a lobbyist, your voice is infinitely stronger and more important, and members [of Congress] listen to you far more than they listen to any lobbyist.”
