HEALTH CARE BRIEFING: Hospitals Eye Spending Bill to Stop Cuts

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Hospital groups are asking lawmakers to prevent billions of dollars in Medicare pay reductions next year as part of a government funding bill that’s on Congress’s agenda for this week.

The Coalition to Protect America’s Health Care, which represents hospital groups, announced yesterday it will launch a television ad campaign in Washington, D.C., urging Congress to stop the cuts.

Some of those same hospital lobbies, such as the American Hospital Association and the Federation of American Hospitals, sent a letter to congressional leaders asking for action before the end of the year and warning that hospitals already face increasing supply costs due to the Covid-19 pandemic.

“Additional Medicare reductions to providers are not sustainable and put our members’ ability to care for their patients at risk,” the groups warned in their letter.

One hospital lobbyist said the groups are pushing for action this week to stop cuts set to take effect at the end of the year. Congress must pass legislation to fund the government by Dec. 3 or the government will partially shut down. Leaders are considering a measure that would run to mid-to-late January.

Medicare fee-for-service payments could be reduced by $14.1 billion in 2022 unless there’s action by the end of the year, according to the AHA, because of mandatory spending sequestration under the Budget Control Act and statutory pay-as-you-go (PAYGO) requirements — two mechanisms meant to limit federal spending.

Hospitals are asking Democratic and Republican leaders to agree to waive PAYGO, something Congress has done to prevent across-the-board cuts to federal programs triggered when lawmakers pass bills that add to government spending without some kind of offset.

They’re also asking lawmakers to postpone sequestration — automatic cuts to federal spending meant to help with the deficit — to the end of the federal public health emergency around Covid-19, which is set to expire in mid-January but is likely to be extended further into 2022. Read more from Alex Ruoff.

Also on Lawmakers’ Radars

Biden’s Big Bet on Family Care Risks Payoff After 2022: President Joe Biden promises cheaper and more accessible care for children, the elderly and disabled once his $2 trillion social spending package passes Congress, yet it will take years to set up programs to help struggling families. To deliver on the heart of Biden’s economic agenda, policy makers will have to address worker shortages worsened by the pandemic and scale up business sectors that already struggle with lengthy waiting lists. They also must galvanize state bureaucracies that face their own political and financial constraints.

The risk of delay in delivering tangible results hangs over Biden and Senate Democrats, who return this week to continue deliberations on the tax-and-spending legislation with next year’s midterm congressional elections fast approaching. “What matters is what people see in their lives, not what politicians tell them,” said Tom Davis, who headed House Republicans’ campaign arm when he served in Congress. “It’s your word versus mine in a campaign until the benefit actually comes in.”

Massive federal programs often take years to fully get off the ground. The health insurance exchanges at the core of President Barack Obama’s Affordable Care Act didn’t open until three and a half years after the legislation became law and then it took several months to fix glitches that plagued online enrollment. But in the immediate aftermath, the law was unpopular and Democrats lost control of the House and saw their comfortable Senate majority whittled down. Read more from Mike Dorning and Jarrell Dillard.

Sanders Wants Revenue from SALT Measure for Medicare Expansion: Sen. Bob Menendez (D-N.J.) said his talks with Sen. Bernie Sanders (I-Vt.) about an income cap for a state and local tax deduction are in trouble. Sanders said in an interview he wants a $400,000 income cap that would raise a couple hundred billion dollars for spending he wants on Medicare dental and vision care, among other priorities. Sanders said Menendez wants a higher cap that does not raise revenue, but the two are continuing to discuss the issue. Read more from Erik Wasson and Laura Davison.

Anti-Addiction Advocacy Groups Press Congress on Policies: Drug policy groups are pushing for Congress to help stem the rising number of overdose deaths in the U.S, Alex Ruoff reports. More than 260 organizations, including the Drug Policy Alliance and National Harm Reduction Coalition, today asked lawmakers to pass a list of policies and bills before the end of the calendar year, including $69.5 million in fiscal year 2022 for funding to increase access to overdose prevention, harm reduction, and syringe service programs at the CDC; as well as legislation such as the Support, Treatment, and Overdose Prevention (STOP) of Fentanyl Act; and The Medicaid Reentry Act, currently included in the reconciliation bill.

The Coronavirus Pandemic

U.S. Recommends Boosters for Adults: The CDC is now recommending booster shots for all vaccinated people 18 and older as scientists race to study the emerging omicron variant. The guidance, which previously said adults “may” get boosters, now says they “should” get a third dose of the Moderna or Pfizer shot six months after their second dose. The same recommendation applies to those who received the single-shot Johnson & Johnson vaccine but after only two months. Read more from Fiona Rutherford.

Biden Warns Against ‘Panic’ Over Omicron, Urges Boosters: Biden cautioned Americans against panicking over a new variant of the coronavirus recently found in South Africa. “This variant is a cause for concern. Not a cause for panic,” Biden said at the White House after a private briefing from his health advisers. He urged people to get vaccinated and obtain booster shots, and to wear masks in indoor public places. Biden said his administration doesn’t yet think new formulations of coronavirus vaccines will be necessary, but that it’s already working with Pfizer and Moderna on contingency plans.

He said he’ll issue a new strategy to combat a winter surge of coronavirus on Thursday, but that the U.S. will not have to undertake further lockdowns or shutdowns. Read more from Josh Wingrove and Nancy Cook.

  • But two former FDA vaccine scientists and a scientific adviser say concerns that the omicron variant could evade vaccine efficacy underscore the need to hold off widespread boosting and focus on getting the shots to the unvaccinated. “The data does not show that every healthy adult should get a booster. Indeed, the push for boosters for all could actually prolong the pandemic,” they wrote in a Washington Post op-ed published yesterday. Jeannie Baumann has more.
  • Covid-19 rapid tests such as Abbott’s BinaxNOW should be able to pick up the variant, potentially lending a critical tool to curbing the spread of the new strain. Anthony S. Fauci, the White House’s chief medical adviser for Covid-19, said yesterday that his South African colleagues told him “at least some of the rapid antigen tests” could detect the variant first discovered by South African scientists last week. Read more from Jeannie Baumann.

More Headlines:

Firing Unvaccinated Workers Discouraged Before 2022: Federal workers who have defied Biden’s vaccine mandate likely won’t be fired until 2022 at the earliest, with the White House encouraging education and counseling as a first step. The vaccine rule for the 3.5 million-person federal workforce took effect last week. In a letter yesterday, the Office of Management and Budget said it “encouraged” managers to stick to education, counseling and at most letters of reprimand for unvaccinated employees until Jan. 1. “We believe this approach is the best one to achieving our goal,” the letter said. Josh Wingrove has more.

Vaccine Exemption Bids for Health-Care Workers to Spark Lawsuits: The Covid-19 vaccine mandate for health-care workers could spark an uptick in litigation challenging the denial of medical and religious exemptions to the controversial rule. The interim regulation from the Centers for Medicare & Medicaid Services requires more than 17 million employees to be fully vaccinated by Jan. 4, 2022. But it also allows workers to forgo the shots if they have valid religious objections or medical reasons.

A federal court in Missouri yesterday blocked the Biden administration from enforcing the vaccine mandate for health-care workers in 10 states. The preliminary injunction by the U.S. District Court for the Eastern District of Missouri marks the first victory for opponents of the mandate. Read more from Tony Pugh and Allie Reed.

  • Meanwhile, a U.S. Supreme Court justice turned away a request from eight Mass General Brigham workers for a religious exemption from the Massachusetts hospital system’s requirement that they be vaccinated against Covid-19. Justice Stephen Breyer rejected the request without requesting a response from the hospital or referring the matter to the full, nine-member court. Breyer, who is assigned to handle emergency matters from Massachusetts, gave no explanation. Read more from Greg Stohr.
  • And in New York City, the Second Circuit ruled 15 public school teachers and administrators must have their requests for religious accommodations from the city’s Covid-19 vaccine mandate reconsidered because the mandate may violate their First Amendment rights. The decision leaves in place temporary relief that stayed the deadline for the workers to opt into the leave program offered for unvaccinated workers while their requests are reheard. Patrick Dorrian has more.
  • Employers are split on whether to require the Covid-19 vaccine of their workers even as the disease continues to spread, variants emerge, and federal vaccine requirements remain in legal suspension. Fear of resignations is making the quandary over employer mandates even murkier, according to a new survey released today. That divide is particularly apparent in the health-care, hospitality, and manufacturing industries, where many workers remain skeptical of vaccinations, employment attorneys say. Read more from Erin Mulvaney.

Pfizer, Merck Pills Threaten Global Equity: Pfizer’s and Merck’s rollouts of Covid-19 treatment pills threaten to exacerbate inequities in pandemic treatment access as the global community braces for the impact of the new omicron virus variant. Licensing agreements with the UN-backed Medicines Patent Pool open the doors for multiple generic drug producers to put out their own versions of Pfizer’s and Merck’s pills to treat those infected with Covid-19 in overseas markets. But some policy experts say the deals are limiting in nature, cutting off swaths of the globe in dire need of treatment in the name of high prices. Read more from Ian Lopez.

More Headlines:

What Else to Know Today

Justices Skeptical of HHS Changes to Hospitals’ Extra Payments: A majority of justices on the Supreme Court seemed hesitant yesterday to reinstate a 2005 rule that in many cases cut the amount of additional Medicare payments hospitals get for serving a larger share of poor patients. The case was a complicated one that seemed to frustrate the justices during hour-long arguments. Justice Clarence Thomas called the rule’s language indecipherable while Justice Brett Kavanaugh rattled off at least five problems with the Department of Health and Human Services regulation. At issue are changes the HHS made to how the supplemental payments, known as disproportionate share hospital adjustments, are calculated. Read more from Lydia Wheeler.

More Headlines:

With assistance from Alex Ruoff

To contact the reporter on this story: Brandon Lee in Washington at

To contact the editors responsible for this story: Zachary Sherwood at; Giuseppe Macri at; Michaela Ross at

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