[Congressional Record (Bound Edition), Volume 148 (2002), Part 15]
[Extensions of Remarks]
[Page 21195]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    ACCESS TO QUALITY HOSPITAL CARE

                                 ______
                                 

                          HON. TED STRICKLAND

                                of ohio

                    in the house of representatives

                      Wednesday, October 16, 2002

  Mr. STRICKLAND. Mr. Speaker, I come to the floor today to call for 
action on legislation to ensure that my constituents will continue to 
have access to quality hospital care. Unfortunately, hospital 
reimbursements and payments under Medicare and Medicaid are at risk 
because, despite strong bipartisan support on these specific issues, 
Congress has failed to complete work on legislation that will provide 
the necessary relief and avoid rising costs. Therefore, I call on my 
colleagues in the leadership of the House to pass H.R. 854 or other 
provider reimbursement legislation now in order to ensure my 
constituents continue to have access to quality health care.
  The Disproportionate Share Hospital (DSH) program is an essential 
piece of our country's health care safety net, protecting children's, 
public, and other safety net hospitals that care for a much larger 
volume of Medicaid patients than typical hospitals. The DSH cuts were 
first enacted by the Balanced Budget Act of 1997 but were postponed by 
the Benefits Improvement and Protection Act (BIPA) in 2000. Despite 190 
bipartisan cosponsors on H.R. 854, which would reverse these cuts, they 
are now scheduled to take full effect, creating financial ruin for 
public hospitals across the country that provide uncompensated care to 
those in need.
  The scheduled cuts in Medicaid DSH is expected to amount to about 
$53.2 million for Ohio hospitals in fiscal year 2003 alone. This cut 
skyrockets to $108 million through fiscal year 2004 and $279 million 
over the next five years. As a result, hospitals will lose an average 
of 15.7% in payments from Ohio's Hospital Care Assurance Program 
(HCAP).
  Hospitals in my district cannot afford these cuts. Already, the 
program reimburses hospitals for less than half of the uncompensated 
care they provide. Reductions in DSH will hurt my constituents, who 
will be forced to pay for overall higher health care costs.
  I also call on my colleagues to complete our work on relief for 
hospitals in rural and other small communities. These hospitals face 
unique challenges compared to those in larger urban areas. 
Specifically, we should standardize the rural/urban disparity in the 
Medicare Inpatient Prospective Payment System (PPS) so that all 
hospitals receive the same payment levels as those in large urban 
areas. We should also expand Medicare's Critical Access Hospital (CAH) 
program to allow more hospitals to qualify for CAH status, enabling 
them to provide care to communities, such as those in rural parts of 
Ohio, where these health care services are desperately needed. In 
addition, I support a full inflationary update for Medicare PPS 
payments to sole-community hospitals. I am glad the Medicare 
legislation that passed the House included several important provisions 
that are a good first step to the funding problems of rural health 
care. I hope my colleagues will do all they can to ensure these 
provisions are enacted before the end of this session.
  And finally, I conclude with a legislative success story. This year, 
Congress passed and the President signed into law the Nurse 
Reinvestment Act, which has the potential to address the current 
nursing workforce shortage by establishing grants and initiatives to 
encourage students to enter nursing school, increase the number of 
nursing school faculty and mentors, create scholarships for nursing 
students who agree to serve in underserved areas, and provide career 
ladder opportunities for current nurses. Although the nursing workforce 
shortage is just one part of the health care workforce shortage, 
passage of this bill is a huge success for both nurses and hospitals 
who are struggling to meet our health care demands.
  However, Congress must fully fund this new law through appropriations 
if its passage will have any positive effect on the nursing workforce 
shortage. I strongly support full funding and hope these appropriations 
are committed soon. Ohio hospitals and the patients they serve are 
depending on it.

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