NASH Unveils 2020 Advocacy Agenda

The National Alliance of Safety-Net Hospitals has published its 2020 advocacy agenda.

To advance the interests of private safety-net hospitals, in the coming year NASH will:

  • Continue to address the major policy challenges of 2019 that had not been resolved as that year ended:  an extended delay of Medicaid disproportionate share (Medicaid DSH) cuts, surprise medical bills, and prescription drug prices.
  • Respond to administration-driven policies such as the calculation of Medicare disproportionate share (Medicare DSH) payments, reduced payments for prescription drugs under the 340B prescription drug discount program, and efforts to reduce Medicaid eligibility and benefits and to limit the means through which states may finance their share of Medicaid payments.
  • Respond to expected judicial decisions addressing the extension of site-neutral Medicare outpatient payments to additional outpatient settings and the implementation of a new public charge regulation.

For a more detailed look at NASH’s advocacy plans for the coming year, see its complete 2020 advocacy agenda.

Braving the Unknown, States Increase Medicaid Benefits

Despite the prospect of Congress and the administration enacting major reductions of federal Medicaid spending as part of repealing and replacing the Affordable Care Act, more than half the states expanded their Medicaid programs in 2017 and many plan to do so in 2018 as well.

In all, 26 states expanded or enhanced Medicaid benefits this year while 17 plan to do so next year.  Most of the changes involve enhancing mental health and substance abuse treatment services.

Learn more about expanded Medicaid benefits in the face of anticipated reductions in Medicaid spending in this Healthcare Finance News report.

NAUH Expresses Views on Health Reform Proposal

NAUH does not support the American Health Care Act in its current form, the organization told members of the House of Representatives in a letter it sent yesterday.

In its letter, NAUH noted that the recently proposed AHCA would result in millions of Americans, many of them Medicaid beneficiaries and low-income individuals and families, losing their health insurance over the next ten years.  Private safety-net hospitals serve especially large numbers of these patients.

In addition, the bill inadequately indexes future growth in federal Medicaid spending; proposed two years of reduced Medicaid disproportionate share (Medicaid DSH) payments in some states; and calls for reduced federal funding for the Affordable Care Act’s Medicaid expansion population in a manner that NAUH believes could lead to some combination of tightened Medicaid eligibility requirements, reduced benefits, and reduced provider payments.

For these reasons, NAUH does not support the AHCA in its current form.

In its letter, NAUH also expresses hope that Congress will consider addressing these issues when it refines and improves the bill.

The ACHA proposal would repeal and replace the Affordable Care Act.

See NAUH’s letter to Congress here.

Perspective on Medicaid

A new report looks at how Medicaid has affected the health and health care of people throughout the country.

The Commonwealth Fund report “Understanding the Value of Medicaid” examines the impact of the Affordable Care Act’s expansion of Medicaid and notes that the program currently serves 73 million children, seniors, low-income working adults, and people with disabilities.

commonwealth fundIt also examines how Medicaid expansion has enhanced access to care and even given some people medical benefits comparable to those offered by private insurance.

Finally, the report notes that safety-net hospitals that serve especially large numbers of low-income patients now serve fewer uninsured patients and are better able to invest in new staff, clinics, and equipment, thereby enhancing the quality of care they deliver.

For a closer look at the impact Medicaid has on the American health care system, see this Commonwealth Fund report.