2019 FEDERAL LEGISLATIVE PRIORITIES – OTHER ITEMS
UAB Biomedical Research Corner
The BBA supports the continued development of the University of Alabama at Birmingham’s Interdisciplinary Biomedical Research Corner through a substantive investment in the Genomic Medicine and Data Sciences Building. This complex, once completed, will provide new research space for interdisciplinary biomedical research, including investigators from multiple schools working on common themes. The complex would house researchers studying medical informatics, personalized medicine, cybersecurity and the analysis of “big data.” This is an important opportunity for the state to invest in new jobs and economic development in the Birmingham area.
Federal Historic Tax Credit
The BBA supports the Federal Historic Tax Credit (HTC) program, an investment that is critical to economic growth in the Birmingham region. In the past 15 years, there have been over 41 federal HTC projects in the Birmingham area alone. Statewide, between 2002 and 2016, 4,466 jobs were created as a result of the program, resulting in over $281 million in total development. The BBA opposes eliminating or decreasing the credit.
New Market Tax Credits
The BBA supports New Market Tax Credits (NMTC) to incentivize community development and economic growth. For every $1 invested by the Federal government, the NMTC program generates over $8 of private investment. The BBA opposes eliminating the NMTC program.
Sugar Policy Modernization Act of 2017
The BBA supports modernizing the U.S. sugar program through the passage of the Sugar Policy Modernization Act of 2017. The bill will make needed reforms to the current federal sugar support program that frequently keeps our sugar prices excessively high relative to our global competitors. The Sugar Reform Act would ensure no net cost to taxpayers, repeal domestic supply restrictions and reduce market distortions caused by sugar import quotas.
The BBA supports the expeditious construction, full funding and timely completion of the Northern Beltline as an essential component of the Appalachian Development Highway System (ADHS). The BBA also supports continued 100 percent federal funding for the ADHS, the appropriation of funds over and above Alabama’s formula apportionment, and inclusion of the ADHS in any infrastructure proposal from Congress or the current administration. The BBA encourages consideration of non-traditional funding solutions in order to accelerate completion of this transformational project through a mix of local, state, federal and public-private partnerships. The BBA opposes any effort to limit the amount of available funding or reduce the national priority status for the completion of the ADHS and this project.
Bus Rapid Transit
The BBA supports the Birmingham Bus Rapid Transit (BRT) initiative, Birmingham Xpress, and identification of matching funds necessary for full implementation. The BBA supports the City of Birmingham as it pursues future BRT funding opportunities, in addition to the $20 million TIGER grant it received in 2015. Birmingham Xpress is an efficient bus-based transit system that delivers fast, comfortable, convenient and cost-effective services at metro level capabilities. The Birmingham Xpress corridor will be 12.5 miles in length, connecting 25 neighborhoods through 19 stations beginning in Birmingham’s Woodlawn neighborhood and extending westbound through parts of Downtown Birmingham before terminating near the CrossPlex facility. Birmingham Xpress will grow the city’s economy by attracting new development in surrounding neighborhoods, connecting residents to jobs, schools, health care, recreation/entertainment establishments and businesses along the corridor.
Freight Transportation Projects
The BBA supports investment in infrastructure projects that improve freight movements, reduce traffic congestion and strengthen public safety, such as constructing more grade-separated railroad crossings to eliminate bottlenecks and to improve public safety, improving access to intermodal shipping for manufacturers by making freight transfers among trains, trucks and boats more seamless and convenient, and consistently maintaining the interstate and national highway system facilities in a state of good and safe repair.
Graduate Medical Education
The BBA supports funding at the authorized level for pediatric graduate medical education (CHGME) and stable Medicare funding for adult GME programs, which play key roles in training physicians, while ensuring Alabama’s future medical workforce needs are met. Furthermore, the BBA supports medical training program expansion while encouraging research and quality innovation.
“Employee Free Choice Act”
The BBA supports a worker’s right to confidentially decide whether to unionize. To this end, the BBA will oppose the so-called “Employee Free Choice Act” and implementation of its provisions through regulations and the National Labor Relations Board.
Protection of Arbitration and Alternative Dispute Resolution Mechanisms
The BBA supports the availability of arbitration and other alternative dispute resolution mechanisms.
340B Drug Discount Program
The BBA supports legislative efforts to reverse the U.S. Centers for Medicare & Medicaid Services (CMS)-mandated 28.5% Medicare reimbursement cut to 340B providers. The BBA opposes any efforts to weaken the programmatic integrity of the program, including placing user fees, moratoriums or onerous reporting requirements on providers. Efforts to weaken the 340B program will only serve to harm the underserved in our community.
Site Neutral Payment Policies
The BBA supports legislative efforts to reverse CMS imposed Medicare site neutral outpatient payment cuts to hospital providers. Specifically, CMS has misconstrued Congressional intent with its proposal to cut payments for hospital clinic services in “excepted” off-campus hospital provider-based departments (PBDs). CMS also has resurrected a proposal, which it had previously deemed unwise, that would penalize hospital outpatient departments that expand the types of critical services they offer to their communities – preventing them from caring for the changing needs of their patients. We urge Congress to address these punitive policies so that hospitals can continue to provide the highest quality health care.
Rural Emergency Medical Center Act
The BBA supports legislation that Rep. Terri Sewell introduced in the 115th Congress, which establishes a new rural facility designation under the Medicare program, allowing facilities meeting certain requirements to provide 24/7 emergency department care and other outpatient services in vulnerable rural communities and receive enhanced reimbursement rates.
The Fair Medicare Hospital Payments Act of 2017
The BBA supports the Fair Medicare Hospital Payments Act of 2017 (H.R. 1130). This bill would bring equity to the Area Wage Index formula and increase reimbursements for Alabama’s hospitals.
Medicare Wage Index
The BBA supports efforts to reach an equitable resolution on the Medicare Wage Index issue so that hospitals in the region will be fairly reimbursed for the services provided to the Medicare population. The current wage index calculation penalizes Alabama hospitals, which are already some of the most efficient in the country in terms of costs, by paying hospitals in other states almost double what is paid in Alabama for the same care.
The BBA supports meaningful reforms that do not create an additional uncompensated care burden for provider, reduce basic federal funding to the state, or reduce benefits and eligibility for the core federal program.
Medicaid DSH Restoration
The BBA supports a repeal or delay of the $4 billion Medicaid Disproportionate Hospital cuts slated to begin on October 1, 2019 for non-expansion states. Failure to delay or repeal will further weaken Alabama’s health care infrastructure and lead to additional increased provider uncompensated care.
The Marketplace Fairness Act
The BBA supports the Marketplace Fairness Act or similar Congressional legislation that would authorize states, with proper implementing legislation and small business safeguards, to require out-of-state vendors to begin collecting state and local sales tax from their customers and remitting that tax to the appropriate state department of revenue. The legislation would endorse (as the U.S. Supreme Court did in the Wayfair case) the Streamlined Sales and Use Tax Agreement, and require one-stop filing, uniform appeals process, and coordinated tax audits by a “single entity administrator” which, in our case, would mean the Alabama Department of Revenue.
Mobile Workforce State Income Tax Simplification Act of 2017
The BBA supports the Mobile Workforce State Income Tax Simplification Act of 2017. This bill prohibits the wages or other remuneration earned by an employee who performs employment duties in more than one state from being subject to income tax in any state other than the state of the employee’s residence, and the state within which the employee is present and performing employment duties for more than 30 days during the calendar year. The bill would support our increasingly mobile workforce and their employers.
Health Insurer Tax Repeal
The BBA supports H.R. 928 and S. 183, which would repeal the insurance premium tax that was added to the Affordable Care Act. The insurance premium tax, currently in effect, has had a negative impact on insurance rates for small businesses since its implementation.
Short Line Tax Credit Extension
The BBA supports the extension of the Short Line Tax Credit that expired on December 31, 2014. This credit assists the smaller freight railroads across Alabama and the United States with upgrades to their lines enabling them to handle larger, already-existing freight car shipments traveling across our country. The lines of these smaller freight railroads are often the key for prosperity and economic growth for areas they serve.
The BBA supports future federal energy policy that does not disadvantage one region of the United States in relation to others. If a renewable energy mandate is adopted, it should incorporate all clean energy technologies, including hydroelectricity, nuclear, clean coal with carbon capture and sequestration, and natural gas, so that the most affordable and efficient clean energy solutions can be deployed for Alabama consumers.
The BBA supports efforts to provide adequate infrastructure to meet the state’s needs for municipal and industrial water supply, navigation, energy production, economic development, irrigation and recreational uses. This includes continued funding for the Drinking Water & Clean Water State Revolving Loan Fund programs and providing funding for the Water Infrastructure Finance & Innovation Act (WIFIA) and the Water Resources Development Act (WDRA).
The BBA opposes the expansion of federal jurisdiction under the Clean Water Act to allow federal agencies to regulate ditches, culverts and pipes, desert washes, sheet flow, erosional features, and farmland and treatment ponds as “waters of the United States” subjecting such waters to all of the requirements of the Act (see the “Clean Water Rule,” 80 Fed. Reg. 37,054 (June 29, 2015)).