Starting a new job usually comes with some uncertainty. Then there’s starting a new job representing hospitals in the middle of a pandemic.

That’s the task facing Stacey Hughes, who in January joined the American Hospital Association (AHA) in its top government relations role. She is taking over for the retiring Tom Nickels, who has worked at the association since 1994 and whom she describes as “a bit of a legend.”

Hughes is largely working from home for now but going into the office in downtown Washington about twice a week.

“I think we’re being very cautious about that, but I am trying to at least see where the office is,” she joked in a recent interview with The Hill.

Hospitals are still on the front lines of battling COVID-19. While hospitalizations have fallen steadily from their peak in January, more than 40,000 patients across the country are in the hospital with the virus.

Through the Provider Relief Fund passed in last year’s coronavirus aid bills, Congress has given $178 billion to health care providers, though the AHA pushed for an additional $35 billion in the American Rescue Plan that was signed into law this month. That total ended up being $8.5 billion targeted at rural health care providers, but Hughes said her association will keep pushing for the full $35 billion, as well as a delay in the return of a 2 percent cut to Medicare payments known as the sequester.

Also looming, now that Democrats control both chambers of Congress and the presidency, is the potential push for a government-run, public option health insurance plan to compete alongside private insurers. Hospitals have long opposed such a plan, concerned that it would pay them less than private plans, particularly threatening rural hospitals.

“We are very concerned about any movement toward that direction,” Hughes said. “I think that it would be a negative, certainly from a financial perspective, and we will continue to advocate against that.”

Any such proposal faces an uphill battle in the 50-50 Senate, and it is unclear what health care policies could pass through the rules of the complicated fast-track procedure known as reconciliation.

“I would imagine that some folks will make an effort,” Hughes said, but added there is more “common ground” around building on the Affordable Care Act without a public option.

The American Rescue Plan signed by President Biden this month already started on that approach, increasing financial assistance under ObamaCare, in a move welcomed by the industry, without taking any steps toward a government-run option.

“We will work hard against that proposal,” Hughes said of a public option. “But in general, I think our hope is that the emphasis focuses on building on what’s working well.”

As legislative proposals grow, a major task of any industry association in Washington is meeting with lawmakers and their staff to try to shape the efforts. But in the age of COVID-19, in-person meetings are out, and Zoom meetings, phone calls and texts are in, meaning the community aspect of going to Congress and running into people in the cafeteria or on the way to a meeting has disappeared, at least temporarily.

Hughes got her start on Capitol Hill with former Sen. Connie Mack III (R-Fla.) after he was elected to the body in 1988.

She spent 18 years working in the Senate, including for then-Sen. Don Nickles (R-Okla.), before helping found the Nickles Group with him when he retired in 2005. Hughes worked there, including on behalf of the AHA, until taking on her new role this year.

She says that background gives her plenty of relationships to draw on, even when there are no in-person meetings.

“One of the things that’s fortunate in being in this town as long as I have been, you have a lot of relationships and colleagues and friends over many, many years,” she said. “Having that reservoir of relationships has certainly proved to be a great value, in particular, because you do have these contacts already, and you’re not making a new relationship.”

When not wading through the world of health policy, Hughes likes to meet up with family at a gathering place in the South Carolina Lowcountry, which also helps her feel in touch with her Southern roots as a Florida native who went to Florida State University.

As vaccinations increase and quarantine conditions start to wane, she’s looking forward to spending more time at the office and having “the ability to quickly put your head into someone’s office and say hi,” as well as potentially more rest and relaxation for some of her colleagues who “have really worked around the clock in trying to ensure that hospitals have what they need” during the pandemic.

“Obviously, we continue to have improvements in vaccination rates, as we sort of land the plane, if you will, I can be part of that process,” she said. “But there’s still obviously a lot going on.”