MJAM2020
5 hours ago
Hundreds of healthcare groups urge Trump to protect Medicaid
January 24, 2025
By Ron Southwick
Health leaders are worried about the prospect of reduced aid to Medicaid, which they say would reduce access to care and deal a financial blow to hospitals.
More than 400 organizations are urging President Donald Trump to protect the Medicaid program.
Hundreds of organizations have written a letter urging President Trump to preserve funding for Medicaid. Analysts say cuts to the Medicaid program would reduce access to care and pose a financial hardship for hospitals.
Trump has vowed to cut government spending, and some healthcare leaders are worried that Trump could look at Medicaid as a place to find savings. Trump has said he’s not planning for any reductions in the Medicare and Social Security programs, and some industry analysts and leaders are worried that Medicaid could see cuts.
On Trump’s first day in office, Families USA and more than 425 healthcare organizations, unions and other groups sent a letter to the president imploring him to protect the program.
Medicaid covers 80 million Americans and helps them get essential care. Healthcare leaders also are making the case that Medicaid provides critical funding to hospitals, including rural hospitals. Analysts note that cuts to the Medicaid program would deliver a financial blow to hospitals, and many providers are still struggling in the wake of the COVID-19 pandemic.
“The importance of Medicaid cannot be overstated,” the letter states. “Medicaid provides insurance for 38 million children and covers more than 40 percent of all births in the country, allowing mothers to deliver safely and children to have a healthy start to life. It is the single most important source of financial support that keeps rural hospitals open to serve the health needs of their communities.”
The groups include the American Public Health Association, the American Association on Health and Disability, the March of Dimes, the National Alliance on Mental Illness, and many others.
In the letter, the groups point out that Americans went to the polls to express their outrage over higher costs for basic needs, including healthcare.
The groups argue that cuts would hurt health systems and states. Beyond cuts in funding, they said they don’t want the Trump administrations to move to block grants, institute work requirements, or take other steps that would “undermine the fundamental structure of the Medicaid program.”
“If instituted, Americans will lose access to lifesaving services, states will be strapped with massive budget holes, hospitals and clinics will lose revenues and be forced to cut staff and scale back services, and American families and workers will be unable to afford essential care and get sicker — leading to a loss in productivity and the economy suffering as a result,” the groups say.
While Trump has not announced cuts or significant changes to the Medicaid program, he has established the Department of Government Efficiency, headed by Elon Musk, to find places to reduce spending.
Hospitals would pay a steep price if there are significant reductions to Medicaid, according to an analysis released last week by Moody’s Ratings. Moody’s also pointed to the impact of reducing subsidies supporting the Affordable Care Act.
“Hospitals could suffer from significant federal funding cuts and regulatory changes affecting Medicaid and state directed payments (SDP), which are administered by state Medicaid agencies but approved by the federal government. A reduction in Medicaid or SDP funding would disproportionately impact hospitals in states that expanded Medicaid under the Affordable Care Act,” the Moody’s report stated.
Lisa Kidder Hrobsky, senior vice president of federal relations, advocacy and political affairs for the American Hospital Association, says that hospitals are going to be pushing Congress and the Trump administration to preserve Medicaid programs.
“We are definitely prepared, beefing up all of our data on Medicaid, making certain that we are able to tell the best story for Medicaid and the patients and the consumers who are part of it,” she told Chief Healthcare Executive®.
Seema Verma, who directed the Centers for Medicare & Medicaid Services during Trump’s first term, said at the HLTH Conference in October that she expected Trump would be looking at the Medicaid program to see how money is spent and to ensure that aid is going to the intended recipients. Verma also said that a Trump administration would give more deference to the states regarding Medicaid.
https://www.chiefhealthcareexecutive.com/view/hundreds-of-healthcare-groups-urge-trump-to-protect-medicaid
imho
mj
MJAM2020
5 hours ago
https://adriansmith.house.gov/media/press-releases/smith-sewell-reintroduce-critical-access-hospital-relief-act
Smith, Sewell Reintroduce Critical Access Hospital Relief Act
January 16, 2025
Press Release
Washington, D.C. – Today, Reps. Adrian Smith (R-NE) and Terri Sewell (D-AL) reintroduced bipartisan legislation to repeal the Centers for Medicare and Medicaid Services (CMS) 96-Hour rule for Critical Access Hospitals.
The members released the following statements:
“Ensuring unnecessary red tape does not prevent hospitals from providing the care patients need is essential,” said Rep. Smith. “This bill would provide a permanent solution to protect patients and providers from the burdensome 96-hour rule in rural areas where access to care is challenging enough. I thank Rep. Sewell for working with me on this.”
“Far too many of Alabama’s rural hospitals are struggling to keep their doors open, putting at risk the health and well-being of our communities,” said Rep. Sewell. “Our Critical Access Hospital Relief Act would provide urgently needed relief so that critical access hospitals can keep their doors open and focus on caring for patients instead of complying with burdensome and outdated payment rules.”
The Critical Access Hospital Relief Act would repeal the 96-hour rule, which requires physicians at Critical Access Hospitals to certify at the time of admission a patient on Medicare will be discharged or transferred within 96 hours. Providers who fail to comply would risk non-reimbursement.
The legislation is supported by the Nebraska Hospital Association (NHA) and the American Hospital Association (AHA), who released the following statements:
"Critical access hospitals are vital to health care in our rural communities, and we must do everything we can to keep them strong. These hospitals allow Nebraskans to get health care in a familiar setting close to where they live and work. Unfortunately, too many rural hospitals are at risk and too many elected officials are ignoring this crisis. The Nebraska Hospital Association commends Congressman Smith for his leadership and taking action on this important issue," said Jeremy Nordquist President of NHA.
"The American Hospital Association (AHA) applauds Representatives Smith and Sewell for their leadership in promoting access to care in rural communities. This legislation would allow Critical Access Hospitals (CAHs) to serve patients needing critical medical services that may have lengths of stay greater than 96 hours. CAHs play an essential role treating patients and saving lives each and every day, and this legislation is long overdue for rural hospitals to be able to provide the types of services their communities need and seek close to home," said Lisa Kidder Hrobsky, AHA Senior Vice President, Legislative and Political Affairs.
BACKGROUND:
Smith first introduced legislation to repeal the 96-hour rule in 2014. Since 2018, the rule has not been enforced because of stays initiated by the Trump administration and subsequent waivers.
imho
mj
MJAM2020
5 hours ago
Fingers crossed... https://www.minnpost.com/community-voices/2025/02/three-ways-the-trump-administration-could-reinvest-in-rural-americas-future-health-care-local-economies/
Three ways the Trump administration could reinvest in rural America’s future
To revitalize communities’ health and economies, start with health care.
by Randolph Hubach and Cody Mullen
2 days ago
Rural America faces many challenges that Congress and the federal government could help alleviate under the new Trump administration.
Rural hospitals and their obstetrics wards have been closing at a rapid pace, leaving rural residents traveling farther for health care. Affordable housing is increasingly hard to find in rural communities, where pay is often lower and poverty higher than average. Land ownership is changing, leaving more communities with outsiders wielding influence over their local resources.
As experts in rural health and policy at the Center for Rural and Migrant Health at Purdue University, we work with people across the United States to build resilient rural communities.
Here are some ways we believe the Trump administration could work with Congress to boost these communities’ health and economies.
1. Rural health care access
One of the greatest challenges to rural health care is its vulnerability to shifts in policy and funding cuts because of rural areas’ high rates of Medicare and Medicaid beneficiaries.
About 25% of rural residents rely on Medicaid, a federal program that provides health insurance for low-income residents. A disproportionate share of Medicare beneficiaries – people over 65 who receive federal health coverage – also live in rural areas. At the same time, the average health of rural residents lags the nation as a whole.
Rural clinics and hospitals
Funding from those federal programs affects rural hospitals, and rural hospitals are struggling.
Nearly half of rural hospitals operate in the red today, and over 170 rural hospitals have closed since 2010. The low population density of rural areas can make it difficult for hospitals to cover operating costs when their patient volume is low. These hospital closures have left rural residents traveling an extra 20 miles (32 km) on average to receive inpatient health care services and an extra 40 miles (64 km) for specialty care services.
The government has created programs to try to help keep hospitals operating, but they all require funding that is at risk. For example:
The Low-volume Hospital Adjustment Act, first implemented in 2005, has helped numerous rural hospitals by boosting their Medicare payments per patient, but it faces regular threats of funding cuts. It and several other programs to support Medicare-dependent hospitals are set to expire on March 31, 2025, when the next federal budget is due.
The rural emergency hospital model, created in 2020, helps qualifying rural facilities to maintain access to essential emergency and outpatient hospital services, also by providing higher Medicare payments. Thus far, only 30 rural hospitals have transitioned to this model, in part because they would have to eliminate inpatient care services, which also limits outpatient surgery and other medical services that could require overnight care in the event of an emergency.
Services for pregnant women have also gotten harder to find in rural areas.
Between 2011 and 2021, 267 rural hospitals discontinued obstetric services, representing 25% of the United States’ rural obstetrics units. In response, the federal government has implemented various initiatives to enhance access to care, such as the Rural Hospital Stabilization Pilot Program and the Rural Maternal and Obstetric Management Strategies Program. However, these programs also require funding.
Expanding telehealth
Before the COVID-19 pandemic, telehealth – the ability to meet with your doctor over video – wasn’t widely used. It could be difficult for doctors to ensure reimbursement, and the logistics of meeting federal requirements and privacy rules could be challenging.
The pandemic changed that. Improving technology allowed telehealth to quickly expand, reducing people’s contact with sick patients, and the government issued waivers for Medicare and Medicaid to pay for telehealth treatment. That opened up new opportunities for rural patients to get health care and opportunities for providers to reach more patients.
However, the Medicare and Medicaid waivers for most telehealth services were only temporary. Only payments for mental and behavioral health teleheath services continued, and those are set to expire with the federal budget in March 2025, unless they are renewed.
One way to expand rural health care would be to make those waivers permanent.
Increasing access to telehealth could also support people struggling with opioid addiction and other substance use disorders, which have been on the rise in rural areas.
2. Affordable housing is a rural problem too
Like their urban peers, rural communities face a shortage of affordable housing.
Unemployment in rural areas today exceeds levels before the COVID-19 pandemic. Job growth and median incomes lag behind urban areas, and rural poverty rates are higher.
Rural housing prices have been exacerbated by continued population growth over the past four years, lower incomes compared with their urban peers, limited employment opportunities and few high-quality homes available for rent or sale. Rural communities often have aging homes built upon outdated or inadequate infrastructure, such as deteriorating sewer and water lines.
One proposal to help people looking for affordable rural housing is the bipartisan Neighborhood Homes Investment Act, which calls for creating a new federal tax credit to spur the development and renovation of family housing in distressed urban, suburban and rural neighborhoods.
Similarly, the Section 502 Direct Loan Program through the U.S. Department of Agriculture, which subsidizes mortgages for low-income applicants to obtain safe housing, could be expanded with additional funding to enable more people to receive subsidized mortgages.
3. Locally owned land benefits communities
Seniors age 65 and older own 40% of the agricultural land in the U.S., according to the American Farmland Trust. That means that more than 360 million acres of farmland could be transferred to new owners in the next few decades. If their heirs aren’t interested in farming, that land could be sold to large operations or real estate developers.
That affects rural communities because locally owned rural businesses tend to invest in their communities, and they are more likely to make decisions that benefit the community’s well-being.
Congress can take some steps to help communities keep more farmland locally owned.
The proposed Farm Transitions Act, for example, would establish a commission on farm transitions to study issues that affect locally owned farms and provide recommendations to help transition agricultural operations to the next generation of farmers and ranchers.
About 30% of farmers have been in business for less than 10 years, and many of them rent the land they farm. Programs such as USDA’s farm loan programs and the Beginning Farmer and Rancher Development Program help support local land purchases and could be improved to identify and eliminate barriers that communities face.
We believe that by addressing these issues, Congress and the new administration can help some of the country’s most vulnerable citizens. Efforts to build resilient and strong rural communities will benefit everyone.
Randolph Hubach is a professor of public health at Purdue University. Cody Mullen is a clinical professor of public health at Purdue University.
This article is republished from The Conversation.
Hoping for the best here for all.
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