KHA’s Federal Advocate April 14, 2021

Congress Returns; Votes on Medicare Sequestration Delay Last night, the House of Representatives returned to session after the Congressional spring break by voting on and agreeing to the Senate amendments to H.R. 1868, a bill to delay the Medicare sequestration holiday until the end of calendar year 2021. The bill, which also grandfathers rural health clinics opened in 2020 into the pre-2021 payment model, now heads to President Joe Biden's desk for signature. Every member of the Kansas Congressional Delegation supported extending the sequestration holiday in some public form throughout this debate over the past month. Senator Jerry Moran co-sponsored the final bill. Senator Roger Marshall, Congresswoman Sharice Davids and Congressman Jake LaTurner voted for the final bill. Congressman Ron Estes and Congressman Tracey Mann voted in favor of a Republican alternative that was considered before the Congressional spring break. We appreciate all of them for working to address this critical matter promptly.

Now that Congress is back in session, their table is full as they look forward to the long push through summer. On the docket for the next few months are some big-ticket items, such as:

• An infrastructure bill, a plan for which has already been transmitted by President Biden to Congress • A "care economy" bill focused on health care, education and family leave, which is likely to be announced by the president later this month • The fiscal year 2022 budget, a $1.52 trillion outline that was presented by the president late last Friday.

The infrastructure proposal contains $400 billion over eight years for home and community- based services on the health care front. House committees will start hearings on this proposal this week as they await additional health care items related to the care economy bill such as a possible request by the Biden Administration to establish a public option in the Affordable Care Act's health insurance marketplace. The budget outline includes a request to increase the U.S. Department of Health and Human Services' discretionary spending by 23.5 percent while giving the Centers for Medicare & Medicaid Services its largest increase in 20 years.

Over the break, Senate Democrats requested the Senate Parliamentarian to clarify how many times within a fiscal year Congress could pass a budget reconciliation bill, the mechanism by which the American Rescue Plan was passed by a bare majority vote. The Parliamentarian clarified that two such bills could be passed within a fiscal year, so it is possible that during the calendar year 2021, the infrastructure bill could be done through budget reconciliation pursuant to the fiscal year 2021 budget, and the care economy bill could be done through budget reconciliation after the fiscal year 2022 is passed.

Senator Moran and Congressman Mann visited Newman Regional Health in Emporia last Friday with recently confirmed Secretary of Veterans Affairs Denis McDonough to discuss the hospital's approach to providing quality health care options for local veterans as part of the Community Care Program. Championed by Senator Moran during his time as chairman of the Senate Veterans Affairs Committee (he is now the committee's ranking member or top Republican), Community Care allows veterans to access care at local hospitals rather than exclusively at V.A. hospitals. Secretary McDonough and Senator Moran also visited Wichita, Junction City and Leavenworth. Additionally, Congressman LaTurner visited Stormont Vail Health last Thursday to meet with the hospital's leadership and discuss their priorities. As more members of Congress and their staff receive their COVID-19 vaccinations, we expect they will work with the Kansas Hospital Association staff and Kansas hospitals directly to discuss concerns on federal matters. These are great opportunities to share our story and explain why their partnership is so important.