2018-2019 Federal Public Policy Agenda
The Oregon Association of Hospitals and Health Systems’ (OAHHS) and the Washington State Hospital Association’s (WSHA) joint 2018 federal public policy agenda captures the challenges hospitals/health systems face as they seek to fulfill their missions of serving the health needs of their communities. This agenda aims to achieve five goals:
- Health care coverage and access to high quality services for all residents of Oregon and Washington;
- Delivery system reforms that reward quality and greater value for dollars spent on medical care;
- Predictable and sustainable revenue streams;
- An adequate supply of health care professionals; and
- A common-sense approach to regulating health care providers that ensures accountability, but allows for flexibility to support a transforming health care system.
Sustain and Enhance Coverage:
Washington and Oregon have achieved significant coverage gains through Medicaid expansion, the health insurance exchange and other policies enacted in the Affordable Care Act (ACA). As a result, about 725,000 Washingtonians now have access to insurance. But we must continue to pursue our goal of coverage for all residents. Congress and Department of Health and Human Services should:
- Pursue new strategies to continue to reduce the number of uninsured persons and work to stabilize the individual insurance market in light of the repeal of the ACA’s individual mandate.
- Reject efforts to limit the Medicaid program, restrict access to Medicaid coverage or force more of the burden of Medicaid costs onto states. Funding levels should also reward our states’ efficiencies and lower utilization of health care services.
- Develop strategies that ensure access to affordable health care services for residents of rural and underserved urban areas.
Protect Access to Care:
- The 340B drug discount program allows hospitals to provide financial assistance to patients unable to afford their prescriptions and programs that improve access to services. We oppose further restrictions on this program and support efforts to include:
- Legislation to reverse the 28.5 percent cut implemented January 1, 2018;
- Reforms to enhance the program;
- Legislation to add orphan drugs in the program; and
- Legislation to control high costs for prescription drugs.
- Ensure critical services are available in all communities by protecting federal funding for Medicare and Medicaid payment to hospitals, including:
- Opposition of “site neutral” payment policies for hospital-based departments and clinics
- Restoration of the two percent Medicare sequestration cut;
- Opposition to cuts in graduate medical education;
- Opposition to critical access hospital payment cuts; and
- Opposition to reductions in Medicare bad debt payments; and
- Restoration/delay of Medicaid DSH cuts and ensure reductions are implemented in a fair manner.
- Continue reform of federal behavioral health policies, including policies that:
- Increase the supply of professionals;
- Improve critical information sharing between providers, such as lessening restrictions on substance use disorder information; and
- Fix CMS’s interpretation of the new Institutions of Mental Disease rule for mental health stays greater than 15 days.
- Invest in the health care work force through:
- Continuation of funding for graduate medical education (GME);
- Enhancement of GME opportunities including correcting errors in residency caps, and fully funding the Children’s Hospitals GME Program for pediatric residency training; and
- Fully funding training programs for nurses, nurse educators and other allied health professionals.
- Enact policies that expand access to high quality medical treatment through telehealth and telemedicine capabilities.
- Remove the 96-hour physician certification requirement as a Medicare condition of payment for critical access hospitals and look for additional ways to reduce the regulatory burden on hospitals.