Healthcare legislation ranging from managed-care reforms to Medicare provider payment increases likely will fall from Congress' agenda for the year as it turns its attention to national defense and antiterrorism measures, healthcare lobbyists said last week.
"We're just going to view this week as a write-off and give the Congress and their staff a chance to adjust," said Skip Moskey, spokesman for the National Association of Public Hospitals and Health Systems, which was going to bring in executives to lobby Congress on Medicaid funding last week (See story, below).
"We'll evaluate this week by week, but I think it's much too early for us to know the longer-term impact," Moskey said. "How the president chooses to allocate resources ... is going to have a domino effect for the budget."
"Considering the tragedy, Congress is going to be rightfully focused on national security," said Charles "Chip" Kahn, president of the Federation of American Hospitals. "On Tuesday, everything changed, but we're now in the fog of the tragedy, and I don't think it's clear where the policymakers are going to take us yet."
Added Stephen Cooper, a healthcare lobbyist for the firm FH-GPC, "One health staffer said to me, `Who wants to talk Medicare reimbursement right now?' "
Healthcare lobbyists said congressional leaders are readying stopgap spending legislation to fund government operations at about the current levels through early 2002. They want to clear the legislative calendar to support potential military strikes in the wake of the terrorist attacks on New York and Washington.
Congress may adjourn for the year shortly after completing action on 2002 spending, in part because of security concerns. Lawmakers postponed numerous committee hearings on healthcare policy issues last week as they worked on an immediate response: a $40 billion bill to aid recovery efforts.
Congress had been working toward possible action this fall on a number of healthcare issues, including legislation allowing patients to sue health plans for damages resulting from the denial of covered benefits; possible increases to Medicare payments to hospitals and other providers; comprehensive Medicare reform; covering the drug costs of Medicare beneficiaries; and closure of a Medicaid loophole used to artificially inflate the federal grants to states.
Although that action may grind to a halt, lawmakers and Bush administration officials said they may need to review emergency medical care as part of strengthening a response to potential terrorist attacks.
HHS Secretary Tommy Thompson said his department had been planning a review of quality in "the whole panoply of medical care in America," but those plans may need to be accelerated.
Sen. Edward Kennedy (D-Mass.), chairman of the Senate Health, Education, Labor and Pensions Committee, lauded the work of hospitals in both cities but said emergency care deserves review as part of the government's response to the attacks. "We'll have to take a look at all of that," Kennedy said.
To praise the work of emergency medical personnel, President Bush and first lady Laura Bush visited 791-bed Washington Hospital Center two days after the attacks, meeting briefly with staff and victims.
The hospital has treated 15 victims of the attack. Eight of the remaining 10 patients, many of whom were suffering from burns, were in critical condition.
"I think it was an emotional experience for everyone there but also a very positive experience," said hospital spokeswoman Meghan Stone.
As Congress began work on legislation to aid the recovery, the hospital industry indefinitely postponed an advertising campaign that would urge Congress to fund measures aimed at relieving hospital workforce shortages.
The campaign, which had been targeted to begin Sept. 16, will begin "when it's appropriate," said Etta Fielek, an American Hospital Association vice president and coordinator of the Coalition to Protect America's Health Care, which includes hospitals, health systems and trade associations.
The coalition planned to use the advertisements to promote a $16.2 billion, five-year Medicare spending package.
Congressional Democrats and Republicans ended their bickering over the shrinkage of the federal budget surplus and consented to spending an estimated $157 billion in excess Social Security payroll tax receipts this year; it appeared they wanted to use the funds primarily for antiterrorism measures.
Hospital groups, however, wanted to make it clear that their emergency rooms are part of the national security network.
Public hospitals, for instance, said they were most fearful that Congress and the Bush administration would close a Medicaid loophole-worth some $7 billion a year in unintended federal spending-that many states use to fund public hospitals and nursing homes. That loophole was to be the subject of a Senate Finance Committee hearing last week that was postponed.
Denny Martin, president and chief executive officer of the California Association of Public Hospitals, said her state's public hospitals use some $250 million in Medicaid revenue from use of that loophole to fund trauma care. "Horribly so, this underscores why we need to have public support for services the public uses, not just the uninsured," Martin said.