(Jan. 16, 2025) – This week, I had the opportunity to make the rounds on Capitol Hill with our federal team and Kansas Hospital Association Board past-chair George Stover to meet with members of our congressional delegation and their staff. It's a busy time in Washington, DC, as the federal government's current funding statute expires on Jan. 30, and lawmakers are scrambling to reach a deal to extend some version of the now-expired health insurance exchange enhanced premium tax credits.
While folks are optimistic that funding for the Department of Health and Human Services will be approved in some form before the deadline, the path forward for EPTCs remains unclear despite bipartisan support for their extension in both the House and Senate. Our senators and representatives know that KHA supports their extension, and we made that clear again.
Our meetings, however, centered on the Centers for Medicare & Medicaid Services' ongoing consideration of Kansas' 2026 provider tax preprint and the grandfathering of our 2025 PPS and 2026 CAH/REH state-directed payment rates. At issue is whether Kansas' provider taxes were "imposed" by CMS' prescribed deadlines but within H.R.1's rating period window. If so, the state's direct payments associated with the higher rates will be grandfathered under H.R.1; if not, they won't be, and payment caps at the program's previous levels would eventually go back into effect.
In general, Senator Moran expressed optimism that the changes made to the program for 2025 will be grandfathered. The program's changes, set for implementation in the 2026 application, are more fraught with uncertainty. Although members of our delegation were assured last summer, during consideration of H.R.1, that the bill's language applied to the program's 2026 changes, CMS has been noncommittal recently.
We had productive conversations with Senators Moran and Marshall and with Congressmen Mann and Schmidt about the path forward. We also had positive conversations with the staff of Congressman Estes' and Congresswoman Davids' offices. Nothing is assured, but we know our delegation understands the issues at hand and is fighting on our behalf.
We also discussed a wide range of issues, including REH flexibilities, 340B protection, Rural Health Transformation Program implementation and support for advanced health care profession education. It was a well-timed trip, and I am confident our delegation appreciates and values the input from KHA and our members.
--Chad Austin