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CEO Message

On Federal Issues, Setting a Path for 2020

Next week, your CHA team will represent hospitals and health systems in Washington, D.C., as we meet with several members of the California congressional delegation to make sure lawmakers understand the most important policy issues facing California’s hospitals in 2020.

We start the new year following some good news from the end of 2019. Congress delayed cuts to Medicaid disproportionate share hospital (DSH) funding and postponed action on some concerning proposals to address surprise medical billing.

The delay in DSH funding cuts was, in part, a result of our advocacy to protect vulnerable patients served by our safety-net hospitals. DSH payments offset the cost of the uncompensated care hospitals provide to the uninsured and underinsured, and the cuts proposed would jeopardize access for millions of Californians. As those cuts are delayed only until May of this year, we’ll need to reinvigorate efforts to eliminate them once and for all.

While we managed to avoid passage of some problematic proposals to end surprise billing in 2019, the delay is temporary, as multiple efforts in different House and Senate committees — and strong public pressure — mean this issue will continue to be a priority. In 2020, it will be at the top of our list to ensure Congress understands that hospitals support eliminating surprise billing, but that fixed “benchmark” rates are not the answer.

We need a solution that protects patients, not one that compromises critical resources for their care.

In November, the Centers for Medicare & Medicaid Services published a proposed rule, the Medicaid Fiscal Accountability Regulation, that will have far-reaching significance for how the Medi-Cal program is funded by the federal and state governments. Because this program is so critical to nearly half of California’s children and millions of adults and the hospitals that care for them, CHA is working hard with our state and federal partners to oppose the proposed changes.

Also in 2020, as threats to the Affordable Care Act continue to arise, we’ll work — both in Congress and in the courts — to protect coverage and access. Hospitals’ steady voice and influence will be more important than ever as the law’s various components are questioned.

Major events and other significant national concerns have taken center stage in our nation’s capital at the moment, so we don’t expect any sudden moves on health policy. We do know that, given the presidential election is just 10 months away, lawmakers are looking toward May as a potential deadline to wrap up many key health care issues — including prescription drug pricing, surprise billing, and Medicaid DSH cuts.

Between now and then, we won’t let up in our advocacy to advance and protect your work in caring for patients.

— Carmela