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NOTEWORTHY
Publication Notice
It is with mixed emotions that I relate to you that this is my last Weekly Political Update Report. As of September 6, after 21 years with HCA Healthcare, I'm retiring my keyboard and saying good-bye. It has been a joy and a privilege to have worked within a company such as HCA, with such an outstanding group of people; I'll miss them all and the work here in Government Relations!
Best Wishes -
Pat Brooks
On behalf of our GR team, I want to thank Pat for her 21 years of service at HCA, 19 years of which have been with our GR team. She has been a great asset to our department, and she will be missed. Not only has she been the mainstay of our Weekly GR Newsletter, Pat managed and developed our Investment By State Report which is a critical document for the Company. Pat, we thank you for your wonderful support and service that has benefited so many of us at HCA, and more importantly, your friendship! We wish the best for you and your family in the years ahead.
Vic Campbell
The HCA Healthcare Government Relations Weekly Report will not be published next week, but will resume the week of September 9.
Enjoy your Labor Day Holiday!
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U.S. House and Senate in August Recess
The U.S. House and Senate continue their August recess, and are expected back on the hill on September 9.
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Supreme Court Justice Treated for Malignant Tumor
Justice Ruth Bader Ginsburg, 86, recently received radiation to treat a malignant tumor on her pancreas, the Supreme Court announced on August 23.
"The tumor was treated definitively and there is no evidence of disease elsewhere in the body," the court said.
The news comes after Ginsburg was treated for lung cancer late last year.
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Senator Spearman Visits MountainView Hospital
Pictured left to right as they appear: Keisha Bickham, VP Operations; Linda Doughty, Interim CNO; Senator Pat Spearman; Jeremy Bradshaw, CEO; Jennifer McDonnell, Director of Communications/PR; Grace Gonzalez, Assoc Chief Nursing Officer; Harsha Dave, VP Quality; Kelly Kern, COO; Sara Khara, Associate Administrator; and Tavarres Jefferson, Administrative Resident.
Nevada State Senator and Majority Whip, Pat Spearman (D), visited MountainView Hospital to meet with CEO Jeremy Bradshaw and the executive team. Senator Spearman, who is the current Vice-Chair of the Senate Health and Human Services Committee, enjoyed learning more about MountainView Hospital and what it is currently doing to meet changing health care needs in Las Vegas. Following her meeting, Senator Spearman toured the 25-bed Neonatal Intensive Care Unit and the state-of-the-art simulation center that supports resident education and physician development.
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Senator Murkowski Visits Hospitals
Alaska Senator Lisa Murkowski (R), at the head of the table, addressed a room of administrators and direct care providers at Alaska Regional Medical Center from Alaska Regional, Providence, Alaska Native Medical Center, PeaceHealth Ketchikan, Alaska State Medical Assoc., Alaska Women's Health, Alaska Radiology Assoc., Alaska Primary Care Association, Alaska Chapter of the American College of Emergency Physicians, Alaska Health Services, and the Alaska State Hospital & Nursing Home Assoc. The Senator spoke on a number of health care topics.
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FEDERAL
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Congress Prepares Temporary Funding Bill
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While there are five weeks before the next government shutdown deadline on September 30, it equates to just 13 work days before federal funding expires. House leaders are already preparing lawmakers for another short-term spending extension that keeps the government running until late November or early December.
Congressional leaders are not expected to pick a firm date for that stopgap until just days, or even hours, away from the September 30 fiscal cliff. However, House Democrats are starting to set the realistic expectation of another pre-Christmas funding crunch.
According to House Appropriations Chairwoman Nita Lowey (D-NY), the Senate has a back-log of business, including their 12 annual funding bills. Budget negotiations have consumed the summer schedule, which set new limits on spending. While the bipartisan compromise is widely expected to prevent another government shutdown, it came too late for Congress to negotiate over the specifics of funding for every department, agency, and program of the federal government before the October 1 start of the new fiscal year.
The House will be busy as well, despite the fact that the chamber marked up all of their fiscal 2020 spending measures this summer and passed 10 on the floor. They must now readjust funding levels heading into negotiations with the Senate, since the budget deal provided about $15 billion less than they had initially assumed for non-defense programs and about $5 billion more for the Pentagon. |
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Nursing Shortage Expected to Grow
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According to the Bureau of Labor Statistics, employment for registered nurses is expected to grow much faster than other occupations through 2026; however, jobs will be centralized in key areas of the country, while others will experience steep competition.
Pamela Ograbisz, a nurse practitioner and director of telehealth for LocumTenens.com, an online job board and staffing agency for advanced-practice clinicians, said she's noticed a high demand for specialty-trained nurse practitioners, including psychiatric, cardiothoracic, gastrointestinal and oncology nurse practitioners.
The shortage is a multifaceted problem. An aging workforce preparing to retire; an aging population, many of which will have complex health issues; and limited number of instructors due to classroom space or clinical sites, budget constraints, and insufficient faculty all contribute to the shortage issue. |
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STATE
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Alaska
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Recall Challenge
Alaska Governor Mike Dunleavy (R) is facing an active recall effort; however, thanks to the quirks of Alaska's law, it may have a potential impossible hurdle to overcome.
Launched following his line-item veto cuts of $444 million in the latest state budget, the Dunleavy recall effort has gathered more than 30,000 signatures; enough to get the recall on the ballot. Alaska does not hold an election to replace a recalled governor, so the lieutenant governor would step up to the position, making this recall a little less partisan. But the signatures are not the only challenge petitioners have to face. Nineteen states allow for a recall of a governor, with differing criteria for the purpose of the recall. Alaska requires proof of the malfeasance or judicial recall standard, which requires that the petitioner show a violation of a law, lack of fitness or some manifest incompetence.
In Alaska's case, petitioners must first gather verified signatures amounting to 10% of the turnout in the previous election (in the case of Alaska's 2018 election, this amounts to 28,501), and then have the director of the Division of Elections agree that the reasons stated in the petition meets the cause requirements in Alaska's law. If the director approves this, petitioners must then gather signatures amounting to 25% of turnout (71,252 signatures). Only then would there be a vote. Note that Dunleavy's running mate, Lt. Governor Kevin Meyer, oversees the Division of Elections. And to throw a further wrinkle into the recall, if the Governor loses, there is no replacement election. He would just be replaced by the lieutenant governor.
The signature total may be daunting, but it is not the most significant problem. Gaining the approval of the director has historically been an absolute bar to success in Alaska and other malfeasance-standard states. In the past, the division has rejected recalls against a governor, two state senators and one assembly representative due to a failure to state a valid cause of action. |
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California
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Bill to Extend Open Enrollment
The California Senate will take up a bill, AB 1309, that would extend the open enrollment period for buying Affordable Care Act coverage. Under the bill, which passed the assembly, open enrollment would run from October 15 to January 31. It was drafted in response to the Trump administration shortening open enrollment nationally, which goes from November 1 to December 15 this year.
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Colorado
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John Hickenlooper Officially Announces Bid for U.S. Senate,
Former Colorado Governor John Hickenlooper (D) has officially announced a bid for U.S. Senate, one week after the Democrat abandoned his presidential ambitions. Polls have shown Hickenlooper with a significant advantage both in the primary field and over Republican incumbent Cory Gardner.
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Georgia
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Senator Isakson Resigning
Senator Johnny Isakson (R), who is serving his third term, said on August 28 that he has informed Governor Brian Kemp (R) of his decision to resign, effective December 31. Senator Isakson said his health challenges are taking a toll; his Parkinson's is progressing, and he suffered a fall in July, which he has yet to fully recover from. In addition, this week he had a growth removed from one of his kidneys. Senator Isakson is 74 years old. |
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Mississippi
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Republican Primary Runoff Results
Lt. Governor Tate Reeves defeated former state Supreme Court Chief Justice Bill Waller in the August 27 runoff, with 54 percent of the votes to Waller's 46 percent. Reeves will now go on to face Democrat Jim Hood, the state's Attorney General in the November 5 general election.
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Tennessee
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Representative Cameron Sexton Elected Speaker of the House of Representatives
The House of Representatives, during an extraordinary session of the Tennessee General Assembly, elected Representative Cameron Sexton (R-Crossville) as Speaker of the House. The House Republican Caucus nominated Sexton for the post in July as a result of the early August resignation of then-Speaker Glen Casada (R-Franklin). Speaker Sexton most recently served as House Republican Caucus Chairman and previously was Chair of the House Health Committee.
In a special caucus meeting, Representative Jeremy Faison (R-Cosby) was elected as the group's new Chairman to fill the spot vacated by Speaker Sexton. Chairman Faison previously served as chair of the House Government Operations Committee in the 109th and 110th General Assemblies.
For more on this and new committee assignments click here.
New THA CEO
The Tennessee Hospital Board of Directors has announced the appointment of Wendy Long, M.D., M.P.H., as the Association's new president and chief executive officer (CEO). Dr. Long will join THA in October. She will replace Craig Becker, who is retiring.
She most recently served as the director of the Metro Public Health Department for Nashville/Davidson County. Dr. Long previously held the position of Deputy Commissioner for the Tennessee Department of Finance and Administration (F&A), and served as director for the TennCare program.
A news release was issued to statewide and national media. |
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Utah
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Lawmakers' Rejection of Proposition 3 Is Costing Utahns $2.5M Each Month
According to the state's Medicaid director, by rejecting full Medicaid expansion under a voter-approved ballot initiative, and opting instead for a more restrictive program, Utah lawmakers have rung up millions of dollars in monthly health care costs.
The estimate is about $2.5 million more per month than the state is spending in additional general funds right now, than if the state were under full expansion, Nate Checketts, state Director of Medicaid and Health Financing, told members of the Legislature's Health Reform Task Force.
Citizens originally voted in, by ballot measure, a full expansion of Medicaid under the Affordable Care Act (ACA); however, the Legislature rejected that and enacted a measure (SB 96), which would limit enrollment for anyone earning 138 percent of the poverty level, to 100 percent of the poverty level. The Trump administration rejected the state's waiver that was submitted requesting the change, despite encouragement from his staff to do so.
Roughly 40,000 low-income Utahns enrolled in ACA plans pay "hundreds of dollars out of pocket rather than thousands" that they would under traditional, private health insurance, Checketts said. But those costs are considerably higher than those same patients would face under Medicaid.
"For the full expansion plan," Checketts said, "they would have no premium and would have $4 copays for most of their services."
Checketts also noted that low-income Utahns who missed the most recent open enrollment period for the ACA, perhaps because they anticipated signing up for Medicaid under Proposition 3, are locked out of those plans until later this year, a criticism of SB 96 raised in previous legislative hearings. |
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