(Nov. 20, 2025) - Work on Capitol Hill is back in full swing as Congress looks ahead to the 2025 legislative endgame following the 43-day government shutdown. Members of the Kansas Hospital Association executive committee visited all of Kansas' congressional offices on Tuesday to advocate for Kansas hospitals and ensure our delegation considers our issues.
Top of mind this week is Kansas's provider assessment program. The Centers for Medicare & Medicaid Services released guidance late on Friday, Nov. 14, suggesting that only provider tax programs actively collecting revenue on July 4 of this year would be eligible for the bill's grandfathering provisions. This date coincides with the passage of the One Big Beautiful Bill Act. This appears to go back on the bill's clear intention to include Kansas's provider tax increase to six percent with the 2025 preprint and to include Critical Access Hospitals and Rural Emergency Hospitals in the program with the 2026 preprint.
After many phone calls with our partners and meetings with members of Congress, we feel reasonably assured that the amounts contained within the 2025 provider tax preprint will be grandfathered according to the provisions of the OBBBA, although we are still seeking verification. However, a few issues regarding the 2026 preprint still need clarification. These include CMS's definition of what counts as an imposed provider tax and whether any statutory or regulatory changes are necessary to include Kansas's provider tax rating period within the bill's date range. We will provide updates on these matters as they become available.
Our group also discussed with our delegation the way forward on extending the Affordable Care Act's enhanced premium tax credits. As it stands, if nothing passes Congress before the end of the year, they will expire which will result in hospital uncompensated care increases.
Democrats in both the Senate and House want a straightforward extension with no programmatic changes. Some Republicans in the House support this for a limited number of years. However, House Republicans are likely to consider altering eligibility and funding levels, while Senate Republicans and President Donald Trump favor a health savings account-based program for eligible marketplace consumers. We reiterated our position that the EPTCs are vital for low-income Kansans to obtain health insurance coverage and access care.
Beyond this, we discussed other policy initiatives, including the 340B drug pricing program, expansion of the REH program and backlogs on COVID-era tax credit payments to hospitals. We arrived in Washington, D.C., at the right time, and we hope our discussions will soon benefit Kansas hospitals.