Why it Matters
The House Ways and Means Committee is bringing health system CEOs to Capitol Hill at a moment when Congress is actively reshaping the federal budget, with Medicaid and Medicare squarely in the crosshairs. The hospital CEO hearing, scheduled for April 28 in 1100 Longworth House Office Building, puts health system leadership testimony at the center of a debate that could determine how tens of millions of Americans access hospital care.
Republicans on the committee are working through a budget reconciliation package that includes significant cuts to federal health programs. Hospital executives and their lobbyists have been spending heavily to shape that outcome.
The Lobbying Push Behind the Hospital CEO Hearing
The organizations whose executives are likely to appear before the committee have not been waiting for an invitation to make their case. Lobbying disclosures filed over the past year show sustained, substantial investment from health systems and their trade associations.
The American Hospital Association reported $7,030,000 in lobbying expenditures in the First Quarter of 2025 alone, and $5,720,000 in the Third Quarter of 2025. Its lobbying agenda covers the full range of issues that would come before Ways and Means: Medicare and Medicaid payment policies, the 340B drug program, hospital price transparency, rural health care access, and the tax-exempt status of not-for-profit hospitals.
Tenet Healthcare, a major for-profit hospital operator, reported $610,000 in lobbying expenditures in the First Quarter of 2025 and $1,170,000 in the Second Quarter of 2025. Its disclosed issues include hospital and physician payments under Medicare and Medicaid, House and Senate budgets as they pertain to Medicare and Medicaid, and tax reform.
Smaller regional systems have also been active. Regional One Health reported $50,000 per quarter in lobbying expenditures throughout 2025, focused on hospital infrastructure, workforce, and payment issues. Methodist Le Bonheur Healthcare reported $22,500 per quarter, lobbying on 340B and hospital outpatient departments, as well as surprise medical billing legislation. The Tennessee Hospital Association reported $30,000 per quarter, focused on the hospital area wage index and rural hospital support legislation.
A Committee Member's Preview
The hearing did not emerge without signals from the committee itself. Rep. David Kustoff (R-TN), a Ways and Means member, posted on April 20 that he had met with members of the Tennessee Hospital Association, including West Tennessee Healthcare President Tina Prescott, West Tennessee Healthcare Bolivar and Camden President Ruby Kirby, Baptist Memorial Health Care Vice President of Government Relations Keith Norman, Regional One Health Executive Vice President Tish Towns, Tenet Healthcare Vice President of Government Relations Corey Davison, and Methodist Le Bonheur Healthcare Director of Public Policy and Advocacy Kristen Bland.
"Thank you for providing quality care to patients across West Tennessee," Kustoff wrote. The meeting, days before the scheduled healthcare CEO hearing preview on the committee's calendar, illustrates how hospital executives are working both formal and informal channels ahead of the session.
What Hospital Executives Are Fighting For
The lobbying disclosures health systems have filed point to a consistent set of priorities that will almost certainly shape what hospital executives tell the committee.
Reimbursement rates under Medicare and Medicaid are the central concern. Hospitals have lobbied aggressively against cuts to inpatient payment rates and for adjustments to the wage index formula that determines how much Medicare pays hospitals in different labor markets. The Tennessee Hospital Association specifically flagged the Save Rural Hospitals Act and the 2019 low wage index hospital policy as legislative priorities.
The 340B drug discount program, which allows safety-net hospitals and other covered entities to purchase drugs at reduced prices, has been a recurring flashpoint. Both Methodist Le Bonheur and the American Hospital Association listed 340B as a lobbying priority, reflecting ongoing disputes with pharmaceutical manufacturers and the Centers for Medicare and Medicaid Services over program integrity and eligibility.
Rural hospital viability is another thread running through the disclosures. Dozens of rural hospitals have closed or curtailed services in recent years, and health systems have pressed Congress for payment adjustments and support programs to keep those facilities open.
The Committee and the Stakes
The hearing will be chaired by Rep. Jason Smith (R-MO), who leads a committee with broad jurisdiction over Medicare, Medicaid, and the tax code, all of which bear directly on hospital finances. Rep. Richard Neal (D-MA) serves as ranking member.
The full committee format, rather than a subcommittee session, signals that leadership views the subject as a priority. With reconciliation negotiations ongoing and the budget resolution requiring significant deficit reduction, the committee is under pressure to identify savings from health programs. Hospital executives are seeking to make the case that cuts to Medicare and Medicaid reimbursement would destabilize health systems and reduce patient access, particularly in rural and underserved communities.
The outcome of that argument will have direct consequences for patients. Medicaid alone covers more than 80 million Americans, and Medicare covers roughly 65 million. Payment rate changes that flow from reconciliation decisions would affect what services hospitals can afford to provide and where.
The hospital CEO hearing arrives as Congress faces a hard deadline on the budget package, with Republican leaders pressing to move reconciliation through both chambers before the August recess. Health system leadership testimony on April 28 will land directly in the middle of that timeline.
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