Dave Ramsey, president and CEO of Charleston Area Medical Center in West Virginia, was surprised when staff for Sens. Joe Manchin (D) and Shelley Moore Capito (R) called over the summer to ask if the 956-bed hospital had any projects for which it needed funding.
As a not-for-profit teaching hospital and regional referral center in one of the poorest states in the country, the answer naturally was yes.
The senators asked because, after a 10-year hiatus, congressional Democrats are bringing back earmarks, which allow individual lawmakers to target funding in appropriations bills for specific needs back home.
Manchin and Capito secured a collective $15 million in the Senate’s Health and Human Services funding bill to finance new clinical imaging equipment, an expanded intensive care unit and a new education and research building aimed at attracting medical students to the Charleston Area Medical Center.
“We have a very poor payer mix. We’re not a wealthy hospital. We’re not from a wealthy state, and we’re challenged every year when it comes to capital,” Ramsey said. “To have these three projects be selected is a wonderful thing for us and it takes a little bit of pressure off of our capital needs.”
Not-for-profit hospitals and other providers are slated to get millions of dollars in earmarks through spending bills that could pass as soon as next month.
Congress can allocate about $15 billion in fiscal 2022 for earmarks, which amounts to less than 1% of federal discretionary spending.
Of that, the Senate designated more than $728 billion for health-related projects that would be distributed by the Health Resources and Services Administration, according to a Modern Healthcare analysis.
The House version includes $367 million in earmarks for projects financing the construction and renovation of healthcare facilities, including purchasing new equipment. The House and Senate will have to reconcile the differences between the bills, but the $15 billion cap allows for all the projects that have already been included in appropriations bills to be funded, said Franz Wuerfmannsdobler, a senior adviser for the Bipartisan Policy Center, which has advocated for the return of earmarks.
Most of the earmarks would go to healthcare providers, including not-for-profit hospitals, academic medical centers, community colleges, nursing homes and assisted living facilities, public health departments and local governments, behavioral healthcare providers, and other not-for-profit organizations.
Most of the money is designated for facilities and equipment, given that access to capital can be hard to come by for cash-strapped providers.
Especially since the COVID-19 pandemic began, some of those projects have been on hold, and getting an earmark funded could give them a needed boost.
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