June 29, 2021

The Honorable Charles E. Schumer Majority Leader

U.S. Senate Washington, DC 20510

The Honorable Mitch McConnell Republican Leader

U.S. Senate Washington, DC 20510

Dear Leader Schumer and Leader McConnell:

As representatives of our nation's hospitals and health systems, we are writing to express our concerns about potential offsets that were included in the Bipartisan Infrastructure Framework released last week. We understand the nation must address core infrastructure needs to allow us to continue to serve our communities and our patients. However, we are opposed to the use of an extension of mandatory sequestration, as well as unspent COVID-19 provider relief funds, as financing sources for any infrastructure package.

Our hospitals are committed to caring for patients during this difficult moment in history, and we expect those challenges to remain for the length of the public health emergency and beyond. Congress recognized that hospitals and health systems needed relief from Medicare cuts during the pandemic and we appreciate the recently provided delay through the end of this year in the two percent mandatory reductions. Unfortunately, the Bipartisan Infrastructure Framework lists a continuation of mandatory sequestration as an offset for the infrastructure agreement. Medicare funds should not be used to pay for roads and bridges. We cannot sustain additional cuts to the Medicare program.

Congress recognized the importance of providing relief to health care providers by assigning funds to them over the last year and a half in multiple COVID-19 legislative packages. The need for these funds remains strong, as many health care facilities are still recovering from the impact of the pandemic, and unfortunately caseloads have increased in some areas of the country due to new virus variants and a lack of vaccinations. The Bipartisan Infrastructure Framework lists repurposing unused COVID relief funds as one of the financing mechanisms. As you know, hospitals and health systems and other health care providers are awaiting the distribution of additional dollars in Provider Relief Funds as well as the recently allocated $8.5 billion for rural health care providers. We would ask that none of these COVID-19 health care relief funds be used for the purpose of funding an infrastructure package, given the ongoing need for health care providers to offer assistance to their patients and communities.

Thank you for your consideration of this important request. We look forward to continuing to work with you during this critical time.

Sincerely,

America's Essential Hospitals
American Hospital Association
Association of American Medical Colleges
Catholic Health Association of the United States
Children's Hospital Association
Federation of American Hospitals
National Association for Behavioral Healthcare
Premier healthcare alliance
Vizient, Inc.

cc: Members of the Senate Bipartisan Infrastructure Work Group