grassroots call, july 12, 2011: emergency gac call
TRANSCRIPT
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
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.