Follow the Money: How Industry Is Lobbying To Preserve Reform Law

November 02, 2011 – Road to Reform

by Dan Diamond, California Healthline Contributing Editor

Two years ago this week, then-House Speaker Nancy Pelosi (D-Calif.) unveiled the bill that would become the backbone of the Patient Protection and Affordable Care Act.

It only seems like efforts to repeal PPACA began that day, too.

A series of Republican presidential debates this year have kept criticism of the law <http://www.advisory.com/Daily-Briefing/2011/10/12/Debate-wrap-up>  in the news, and conservative-leaning trade groups, activists and politicians continue their calls for striking down PPACA. While some anti-PPACA fervor has ebbed, criticism of the law may surge again as the Supreme Court next week will consider taking up the case <http://www.californiahealthline.org/articles/2011/10/27/supreme-court-to-mull-review-of-antireform-lawsuits-next-month.aspx>  against reform.

One group continues to remain quiet on repeal: the health industry.

If anything, health insurance companies, device manufacturers, and many provider associations have strong financial motives to keep PPACA in place — and the sector continues to put its lobbying dollars where its pocketbook is.

Health Donations Remain Strong

The Center for Responsive Politics on Monday reported that the health industry remains atop its lobbying charts <http://www.opensecrets.org/lobby/indus.php?id=H&amp;year=2011> . The sector collectively has spent more than $373 million toward lobbying efforts in 2011, led by the pharmaceutical industry’s $181.5 million.

But while the industry in 2010 shifted toward <http://www.californiahealthline.org/articles/2010/10/4/health-industry-leaders-donating-more-to-gop-after-health-overhaul.aspx>  favoring the GOP in some of its donations, ahead of midterm elections that juggled congressional majorities, it remains a staunch supporter of the White House’s current occupant.

Additional Center analysis found that <http://www.opensecrets.org/news/2011/10/barack-obama-health-lawyers-hollywood.html>  President Obama’s re-election campaign has raised $1.6 million from the health care sector, significantly more than his top Republican challengers. (Mitt Romney has collected $920,000 and Rick Perry has brought in $494,000.)

Backing Architect of Current Law

There’s wide perception that the health law imposes new restrictions on businesses, including those in the health sector; as Kaiser Family Foundation’s Drew Altman observed, critics of PPACA often framed it as “a government takeover of the health care system.”

So why the continued industry support for the current government?

Chris Frates at National Journal notes that <http://influencealley.nationaljournal.com/2011/10/obama-rakes-in-more-health-car.php> the health industry “is hedging its bets. The Obama administration still has a mountain of regulations to implement and trade associations and companies don’t want to alienate an administration that holds huge sway over their bottom lines. “ 

But there’s an even more pressing reason for health companies to keep Obama in seat.

There’s limited evidence that the industry would benefit from repealing reform — and a lot of data suggesting that PPACA will be a boon to the sector’s bottom line <http://www.californiahealthline.org/road-to-reform/2011/who-wins-if-republicans-repeal-health-reform-law.aspx> .

Hospitals are expected to benefit <http://www.rwjf.org/files/research/66028hospitals.pdf>  from the law’s expansion of health insurance coverage. Insurers are seizing on new opportunities <http://www.washingtonpost.com/blogs/ezra-klein/post/the-insurance-industry-gets-bullish-on-health-care-reform/2011/09/19/gIQA0HNJgK_blog.html>  in the individual market.

Even some of the law’s more fearsome provisions aren’t turning out as the health sector feared. CMS’ proposal to create accountable care organizations — which providers originally viewed as draconian, given restrictions on payment and potential risk — was toned down and made significantly more industry-friendly <http://www.californiahealthline.org/road-to-reform/2011/when-a-law-loses-its-teeth-can-the-reform-still-bite.aspx>  when the agency finalized the program last month.

Lobbying Focus Shifting To Preserving Programs, Provisions

Meanwhile, it’s hard to foresee what a repeal would actually look like.

As Drew Armstrong and Kristen Jensen write for Bloomberg Businessweek <http://www.businessweek.com/magazine/repeal-obamacare-good-luck-10272011.html> , calling to repeal PPACA may be “a killer applause line” at Republican presidential debates, but actually striking down the law would require a somewhat byzantine series of White House-directed efforts and acts of Congress.

In many ways, fighting over PPACA is last year’s battle. Instead, the industry is concerned with what’s coming this month: the so-called Super Committee and its Nov. 23 deadline for recommendations.

Lobbying efforts are focused on Congress’ deficit reduction panel, which is charged with coming up with $1.2 trillion in cuts over a decade, and federal health spending is squarely in its crosshairs; many expect <http://www.forbes.com/sites/davidwhelan/2011/11/01/10-reasons-the-deficit-super-committee-should-cut-medicare/>  the committee to call for hundreds of billions of dollars in cuts to Medicare and Medicaid.

The pharmaceutical sector also is focused on preserving Medicare Part D’s current structure, pushing back on potential changes to the drug benefit program <http://www.californiahealthline.org/road-to-reform/2011/the-benefits-of-changing-medicares-drug-benefit.aspx>  that would give CMS more negotiating power.

We’ll be watching for the Super Committee’s recommendations, as well as how the health care sector is lobbying to shape them. Meanwhile, here’s what else is making news around the nation.

On the Hill

Challenges to Reform

Rolling Out Reform

In the States

  • Massachusetts officials recently unveiled a proposal to create a managed care program for residents eligible for both Medicaid and Medicare as part of a broader effort to cut spending on dual eligibles. The plan would reduce the $4 billion the state spends on dual eligibles by about 2%. The plan calls for the state to employ “integrated care” organizations that could include private or other third-party insurers and hospital networks, as well as “care teams” that would provide and coordinate acute, behavioral and long-term care services. Massachusetts and 14 other states received grants of up to $1 million from the federal health reform law to overhaul their programs for dual eligibles (Levitz, Wall Street Journal <http://online.wsj.com/article/SB10001424052970204505304577000244207856650.html> , 10/27).

Public Opinion

Administration Actions

Effects on the Elderly

Read more: http://www.californiahealthline.org/road-to-reform/2011/follow-the-money-how-industry-is-lobbying-to-preserve-reform-law.aspx?p=1#ixzz1cfqXR3nt

Advertisements