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Grassroots Call, July 12, 2011: Emergency GAC Call. Today’s Call. 1. Debt Ceiling 2. Rumors rural cuts 3. Cantor’s Proposal. Background. Debt ceiling/August 2 Deadline Must have agreement soon. Will take time to draft legislation This week is critical. Gang of 6 failed - PowerPoint PPT Presentation
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Grassroots Call, July 12, 2011:Emergency GAC Call
Today’s Call• 1. Debt Ceiling
• 2. Rumors rural cuts
• 3. Cantor’s Proposal
Background
• Debt ceiling/August 2 Deadline
• Must have agreement soon. Will take time to draft legislation
• This week is critical.
• Gang of 6 failed
• Joe Biden negotiations failed
• President has taken over negotiations
• “everything is on the table” including rural Medicare payments.
Who’s in the room• President Obama
Senate• Reid – D-NV• Durbin – D-IL• McConnell – R-KY• Kyl – R-AZ
House• Boehner – R-OH• Cantor – R-VA• Pelosi – D-CA• Hoyer – D-MD
• Earlier Biden proposals may have included reworking cost-based reimbursement.
• Now Cantor proposal:• $16 billion in specific rural cuts.
Inside and Outside Strategy
• NRHA has hit and will continue to hit key Congressional targets
• Administration; WH call, HRSA• Outreach to all rural associations
• Grassroots must be fully mobilized• Call and email Member• Go to District Office• Letters to editor
STATE CAH RHCAlabama 2 75Alaska 13 2Arizona 14 18Arkansas 29 72California 31 285Colorado 29 54Florida 13 146Georgia 34 94Hawaii 9 2Idaho 27 44Illinois 51 221Indiana 35 63Iowa 82 142Kansas 83 179Kentucky 30 150Louisiana 27 106Maine 16 39Massachusetts 3 1Michigan 36 157Minnesota 79 81Mississippi 31 168Missouri 36 366
STATE CAH RHC
Montana 48 53Nebraska 65 138Nevada 11 8New Hampshire 13 11New Mexico 7 11New York 13 7North Carolina 23 84North Dakota 36 58Ohio 34 17Oklahoma 34 43Oregon 25 64Pennsylvania 13 63South Carolina 5 109South Dakota 38 57Tennessee 17 62Texas 79 316Utah 11 18Vermont 8 15Virginia 7 46Washington 38 129West Virginia 18 54Wisconsin 58 50Wyoming 16 18
Critical Access Hospitals and Rural Health Clinics By State
RRC MDH SCH
AK 0 0 3
AL 8 8 9
AR 5 3 11
AZ 1 0 6
CA 6 1 14
CO 0 1 11
CT 2 0 1
DE 1 0 0
FL 5 3 6
GA 12 6 10
HI 0 0 5
IA 2 6 2
ID 1 0 1
IL 5 9 7
IN 9 3 1
KS 1 5 11
KY 16 10 3
LA 5 10 5
MA 0 1 1
ME 1 4 4
MI 5 3 13
MN 0 3 8
MO 5 6 10
RRC MDH SCH
MS 13 11 10
MT 2 0 4
NC 8 10 2
ND 0 0 1
NE 1 1 2
NH 1 0 0
NM 1 0 12
NV 0 0 4
NY 4 8 13
OH 8 5 5
OK 6 8 15
OR 2 0 1
PA 9 9 9
SC 3 1 5
SD 0 0 4
TN 6 24 6
TX 7 17 45
UT 0 0 7
VA 3 7 11
VT 0 1 1
WA 3 0 3
WI 2 4 7
WV 6 4 4
WY 0 0 10
Rural Referral Centers, Medicare Dependent and Sole Community Hospitals
Big Plan vs. Little Plan
• $2.4 trillion - $4 trillion
• SGR fix?
• Rural Extenders
The costly Doc Fix• Congress consistently blocks scheduled cuts from taking effect, and
has to come up with new offsets each time.
• According to the AMA, a permanent SGR repeal would have cost $48 billion in 2005 — compared with a price tag of nearly $300 billion to block the cuts that are scheduled for January.
• "An agreement on the debt ceiling legislation provides the best — and perhaps only — opportunity to ensure stability in Medicare payments, ensure continued beneficiary access to care, and address the SGR deficit in a fiscally responsible manner," the AMA and other organizations said Monday in a letter to President Obama.
Rural Provisions set to expire at same time as SGR
• Positive adjustments in the GPCI• Outpatient hospital hold harmless provisions• Extension of the Medicare Dependent Hospital
Program• Section 508 Hospital Payments (reclassification) • Rural Ambulance Super bonus• Technical component cost for certain pathology
services• Low volume/high quality adjustment
The Message
• Don’t support debt ceiling proposal that contains devastating cuts to rural health care.
• $16 billion in Medicare cuts to rural providers will decimate the delivery of health care to the 62 million who live in rural American.
• Rural hospitals are critical to the patients they serve and to the rural economy.