Hospitals to Congress: Don't forget us in COVID-19 stimulus package

Capitol building in Washington
Hospital groups are imploring Capitol Hill to not forget them as lawmakers formulate a massive economic stimulus package to blunt the impact of coronavirus. (rarrarorro/iStock/Getty Images Plus/Getty Images)

Hospitals are making their bid to ensure they aren’t forgotten in a nearly $1 trillion economic relief package Congress is hammering out to blunt the impact of the coronavirus.

Hospital groups say the situation is dire as hospitals are canceling elective procedures to shore up capacity to handle the coronavirus, which has infected roughly 4,200 Americans as of Tuesday. Congress is currently debating a massive economic stimulus package that includes relief for small businesses and Americans to prop up the economy. 

“We are worried people don’t understand the implications of ending elective surgery,” Bruce Siegel, M.D., president of America’s Essential Hospitals, told FierceHealthcare. The group represents safety net facilities that treat a large amount of uncompensated care.

He said most safety net hospitals rely on elective surgeries to keep the doors open. But hospitals are canceling those procedures just as coronavirus cases rise.

“You are going to see huge new costs, a drop in revenue as elective surgery goes away and some hospitals have seven days cash on hand,” Siegel said.

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The group wrote to Congress on Monday asking members to extend access to low-interest loans and increase loan limits. They also want targeted funding to hospitals treating or preparing for coronavirus patients, especially those that have a large Medicare, Medicaid and uninsured population.

The American Hospital Association (AHA), the American Medical Association and the American Nurses Association wrote to congressional leaders on Monday to provide at least $1 billion in supplemental funding that isn’t offset by cutting other programs.

They also want funding to construct separate areas to screen and treat an influx of coronavirus patients and get scarce supplies such as personal protective equipment.

Wednesday, the AHA wrote a separate letter to Congress calling for a temporary extension of financing tools. For instance, the association has called for legislation to enable hospitals and governments to use advance refunding for municipal bonds, which can lower their borrowing costs.

“This would be of immense help for planning and budgeting purposes for state and local communities and organizations, such as hospitals that are first-line responders during this immediate crisis,” the AHA said.

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The group also wants to increase the bank-qualified borrowing limit from $10 million to $30 million to enable hospitals to get capital for any immediate projects.

AHA also seeks payroll tax relief and financial assistance for making infrastructure improvements and to buy needed supplies. Currently, healthcare groups and experts are extremely worried about whether hospitals have enough personal protective equipment and ventilators to treat the expected influx of coronavirus patients.

Hospital groups have also wanted Congress to suspend the 2% Medicare payment cut installed with the sequester.

They want an increase in the federal matching rate for states for Medicaid and a temporary increase in Medicaid disproportionate share hospital (DSH) payments by at least 3%.

“Congress acted to raise Medicaid DSH state allotments by 2.5% for two years during the last economic downturn,” America’s Essential Hospitals said.

The Federation of American Hospitals (FAH) also asked Congress on Monday to amend the Stafford Act, which outlines how to dole out federal emergency funding to states and localities. The FAH said the law must be amended to permit “all Medicare participating hospitals to have access to coronavirus preparedness and response funding.”

But it remains unclear whether Congress will include hospitals in any economic relief packages.

Senate Majority Leader Mitch McConnell said in a press conference Tuesday that a series of Republican-only task forces have been created to work on the next coronavirus package. After Republicans reach consensus, McConnell will reach out to Democrats to get a deal.

He added that he plans to keep the Senate in session until they pass a package. But he didn’t say what that package could include, although some Republicans have endorsed payroll tax holidays or giving cash payments to all Americans.

“We know an additional bill of much larger proportion is needed to meet this crisis,” McConnell said.

The Senate is expected to pass another $100 billion package this week on the virus that includes money for paid sick leave and unemployment insurance. It also includes an increase to the federal matching rate for Medicaid.

President Donald Trump has floated almost $1 trillion in economic stimulus, but so far it remains unclear whether hospitals can get a slice of that money or whether it will get some regulatory relief.

Siegel said his group has been in talks with lawmakers “minute to minute” on the issue. He said that the situation will evolve into a crisis within a week or two as more hospitals shutter elective procedures and cases rise.

“I understand Congress moves slow,” he said. “I would just say this is an unprecedented crisis and hospitals are ready to do their part. We need Congress to do its part.”