AHA’s Congressional “wish list” calls for financial relief, patient access, workforce protections

Editor's Note

In a November 12 letter to Congress, the American Hospital Association (AHA) outlined its priorities for the lame-duck legislative session, focusing on measures to stabilize hospitals and health systems facing significant financial and operational pressures. If enacted, these recommendations would support the nation’s healthcare infrastructure amid rising costs and increasing payer and regulatory demands, authors claim. Specific recommendations include:

• Protecting vulnerable populations through Medicaid Disproportionate Share Hospital (DSH) payment relief. Scheduled for 2025, these cuts would remove $8 billion in support for hospitals serving low-income, disabled, and elderly populations. The AHA seeks to prevent these cuts, arguing that such reductions would compromise care for vulnerable groups and exacerbate existing financial burdens on hospitals.
• Targeted rural access programs. Highlighting rural communities’ dependence on specialized hospital funding, the letter urges Congress to extend the Medicare-dependent Hospital and Low-volume Adjustment programs. It alo calls for allowing Rural Emergency Hospitals to receive Medicaid reimbursement for outpatient services, which would ensure continuity of care in isolated areas.
• Opposing site-neutral payment cuts, which align reimbursements across care settings. The AHA argues these cuts would disproportionately harm hospital outpatient departments (HOPDs), which maintain higher safety standards and serve medically complex Medicare patients, and that further cuts would limit service availability.
• Addressing health plan delays, denials. “Certain health plan practices, such as inappropriate care denials and delayed payments, threaten patient access to care,” the letter reads. “These practices also contribute to clinician burnout and add excessive administrative costs and burdens to the health care system.” AHA supports the Improving Seniors Timely Access to Care Act, which would help reduce delays and administrative hurdles by standardizing prior authorization processes under Medicare Advantage.
• Extending telehealth, hospital-at-home programs. AHA advocates for making telehealth and hospital-at-home waivers permanent. Telehealth expansion would allow providers to serve dispersed patient populations, while hospital-at-home programs could offer a comfortable, cost-effective alternative to inpatient care. The AHA supports legislation to extend these initiatives through 2029.
• Preventing physician reimbursement cuts. With a 2.8% physician payment reduction looming, the AHA warns that failing to address reimbursement cuts could worsen staffing shortages and impede patient access.
• Enhancing healthcare worker safety. The letter voices support for SAVE Act, which would extend federal workplace violence protections to hospital employees, akin to protections for airline workers.