The House Ways and Means Committee majority released a report on the health care sector and climate on Sept. 15 in conjunction with a hearing on the topic. The report followed a request for information (RFI) from committee Chair Richard Neal (D-Mass.) earlier this year.
The report, “Health Care and the Climate Crisis: Preparing America’s Health Care Infrastructure,” was compiled from input the committee received from hospitals, health systems, national organizations, and specialty societies, including the AAMC [refer to Washington Highlights, May 20]. In total, 63 providers and 13 trade associations responded to the RFI.
The data collection and report were aimed at learning about the health care sector’s impact on climate change, best practices to curb those impacts, and opportunities to support organizations in addressing their climate impacts and building resiliency, as the U.S. health care system is known to be responsible for approximately 10% of the country’s greenhouse gas emissions. “Providers, suppliers, and other actors in the health sector have a role to play in curbing emissions and ensuring they are appropriately prepared for increasing climate-related events that will inevitably disrupt operations. Ultimately, such steps have the potential to not only improve health but also provide cost-saving opportunities,” noted the report.
The report included summaries and analyses of respondents’ answers to the RFI, including information on the frequency of extreme weather events in the facilities’ localities, dedicated time and staff to addressing the climate crisis, climate action or preparedness plans, and policy recommendations to better support facilities in addressing climate change. According to the report, the most common recommendations across respondents were: “funding the Hospital Preparedness Program, establishing and expanding renewable energy sources, capacity-building for microgrids, and fuel cell energy storage.”
Both the report and members of the committee’s majority highlighted the recent passage of the Inflation Reduction Act of 2022 (IRA, P.L. 117-169), which included provisions to modify the tax code, allowing non-profit entities to receive direct payment incentives and tax deductions for the renewable energy investments outlined in the law [refer to Washington Highlights, Aug. 15]. The IRA includes tax incentives for clean energy and clean fuel production, charging stations, electric vehicle purchases, and for sustainable infrastructure investments.
Neal opened the hearing by noting that not enough time has been spent thinking simultaneously about how the health care system emissions impact climate, and how changes in the climate are impacting health, including exacerbating health inequities. “Today’s discussion is an important step to understanding the role the federal government plays in supporting how health care facilities both respond to the climate crisis and mitigate their contribution to it. We need to encourage urgent, measurable action. There’s no one size fits all response, but the federal government can move the industry from a piecemeal approach to intentional, comprehensive strategies,” he said.
In his opening statement, Ranking Member Kevin Brady (R-Texas) disagreed with the premise of the hearing, stating, “We should focus on more pressing health care issues facing America, including a crucial shortage of nurses, physician burn-out, delayed payments for health care providers, permanent telehealth reform, intrusive government-mandated health care, a fentanyl crisis, and a social isolation crisis fueled by government shutdowns that more often affect vulnerable populations.”
Witnesses coalesced on the need to work to mitigate climate change and make hospitals more resilient in climate disasters to improve the health of patients. They agreed that the lack of upfront financial resources is often a barrier to sustainable investments and acknowledged the importance of data collection for emergency preparedness and sustainability planning.
Neal stated that the first action needed to address climate change in the health care sector is for the Centers for Medicare & Medicaid Services (CMS) “to put out standards and guidelines so providers would know how and what to track in terms of reporting emissions.” Jodi Sherman, MD, associate professor of Anesthesiology at the Yale School of Medicine and director of the Program on Health Care Environmental Sustainability at the Yale Center on Climate Change and Health, agreed, testifying that the CMS should be used to incentivize mitigation of health care emissions and that emissions should be considered a dimension of the quality of care.
Sherman testified alongside Paul Biddinger, MD, chief preparedness and continuity officer at Mass General Brigham and director of the Center for Disaster Medicine at Mass General; Elizabeth Schenk, PhD, RN, executive director of Environmental Stewardship for Providence; Parinda Khatri, PhD, CEO of Cherokee Health Systems; and Rich Powell, JD, CEO of ClearPath Inc.
Additional responses to the RFI are expected from group purchasing organizations to better understand the role of the hospital supply chain on the climate crisis and impacts of extreme weather to the supply chain.