01a Apocalyptic

Congress may have spent most of the last few weeks out of session. But despite lawmakers decamping from Washington for their home districts, rest assured that the swamp remains alive and well.

A recent story in Politico provides yet another example of how K Street lobbying works — with the former serving as the free publicity arm of the latter. The publication ran a story about hospitals purportedly incurring large losses without including any explanation of or justification for its claims. If there’s a more obvious way to shill for the organizations potentially paying thousands of dollars for subscriptions to one’s publication, I have yet to see it.

At issue in the article: two Medicaid-related provisions of last year’s budget reconciliation bill. The first one involves provider taxes, which most states assess on various groups of medical practitioners (including hospitals) as a fancy way of attracting additional federal matching dollars from Washington. The second involves state-directed payments, supplemental payments that Medicaid programs make — often to hospitals, and often with the state share of the payments financed via provider taxes or similar budgetary gimmicks designed to shift funding from the states to Washington.

The Politico article predicts catastrophe for hospitals:

Hospitals thought losing hundreds of billions in Medicaid funding through GOP-led cuts last year was bad. But coming regulations from the Trump administration could slash their funding even deeper than Congress did. Two recently proposed rules from the Centers for Medicare and Medicaid Services [CMS] would cost hospitals hundreds of billions of dollars more, hospital executives told Politico. …

Hospitals say CMS’ rules restricting state taxes and payments go further than what Congress intended. Hospitals expected to lose $340 billion through 2034 after Congress passed the One Big, Beautiful Bill Act last year. If the rules are finalized as proposed, they would generate $756 billion in savings to the federal government and $265 billion in savings to states through 2035. Or as hospitals see it, they’re losing $681 billion more than they expected.