Congress isn’t done with messy healthcare brawls

The anti-inflation law is law. But that doesn’t mean major health interest groups are done lobbying. Many are already bracing for year-end relief from Medicare payment cuts, regulatory changes, and inflation concerns.

The big picture: End-of-year spending bills often include health-care “extenders” that delay cuts at hospitals that treat the poorest patients or divert money to community health centers. But lawmakers may struggle to justify the price this time and are seeing an unusual array of calls for help.

Background: 2% cuts in Medicare sequestration suspended by the pandemic went into effect last month. Another 4% cut could come by the end of the year if lawmakers don’t delay it.

  • These automatic spending cuts come amid healthcare workforce shortages, supply chain issues, and other stresses that leave providers struggling to find relief.
  • It will be up to Congress to pick winners and losers among hospitals, doctors, home care groups, nursing homes and emergency services. And everyone says the consequences of not helping are dire.
  • “The key question is how do they get the money and how do they decide who to give it to?” said Chris Meekins, an analyst at Raymond James.

go deeper: hospitals are They are pushing hard for an exemption from the confiscation by the end of the year and want Congress to extend or create permanent programs to support rural entities, scheduled to expire on September 30 unless legislative action is taken.

  • The American Hospital Association estimates that its members will lose at least $3 billion by the end of the year.
  • Hospitals in the government’s discount drug program are also in need of recovery after the Supreme Court unanimously overturned a huge pay cut under a 2018 ruling. And the industry is also trying to reverse a planned cut in copayments for unpaid care.

doctors and nursing homes are among the other players lining up for exemptions from sequestration reductions, specific Medicare payment changes affecting their businesses, or new regulations.

  • The American Medical Association says Medicare cuts could threaten medical practices plagued by pandemic-related retirements and burnout. “This is really about enabling patients and Medicare beneficiaries to continue care,” AMA President Jack Resneck told Axios.
  • National Association for Home Care and Hospice President Bill Dombi said more than half of home health departments will fall short if lawmakers don’t act. “When you have so many vendors in the red, you can foresee the negative consequences. They are already refusing 20-30% of referrals for admission to care, which is impacting patients,” Dombi said.

  • Even the emergency services are struggling. “Ambulance providers across the country are on the verge of fracture as we walk down the ledge leading up to this cliff at the end of the calendar year,” Shawn Baird, president of the American Ambulance Association and chief operating officer of Metro West Ambulances in Oregon, said axios.

The other side: Despite Congress’ willingness to delay paying cuts, there isn’t enough money to keep everyone happy. And concerns about the Medicare program’s ability to pay, which arose during the protracted debate over the Democrats’ tax, climate and health care packages, could dampen lawmakers’ enthusiasm for costly solutions that favor one provider group.

  • The continuation of the COVID-19 public health emergency and its myriad temporary payment reliefs may also reduce the sense of urgency around provider relief.

The bottom line: Despite all the dire warnings, Congress is unlikely to do much until December, when it could likely pass a rolling resolution or sweeping spending bill and then delay the 4% cut.

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