Interest Groups Prep for Health Endgame
Roll Call Staff
Industries and advocacy groups with a stake in health care reform legislation are increasingly assuming that Congress will approve an overhaul and are shifting their focus to ensure that their top priorities are protected in the final bill.
Doctors, hospitals, drug companies, businesses and labor unions as well as liberal and conservative groups have spent the past year waging an all-out effort to either shape or kill the legislation. Those campaigns, replete with expensive ad wars and organized citizen rallies, were aimed at moving public opinion and key lawmakers.
But now that the legislation has passed both the House and Senate — and Democratic leaders are huddling to hammer out a final version — lobbyists are scurrying to figure out what will be in the fine print of the ultimate product and how they can make implementation of the bill more palatable for their clients.
“The tea party days are way behind us,” said one longtime health care lobbyist, referring to the anti-health care rallies of the summer. “We are now in the end game.”
Democratic leaders still face challenges in the weeks ahead trying to bridge differences within the party on hot-button issues such as abortion, taxes and whether there should be a public insurance option.
But even some of the most vocal opponents of the Democrats’ health care efforts appear resigned to a bill being signed into law.
“The bow is almost wrapped around the Christmas gift,” said Amanda Austin, a lobbyist for the National Federation of Independent Business, which has criticized the legislation as not doing enough to curb costs for its small business members. Austin said the goal for her organization during the final negotiations is to “try and keep in some of things we want to remain in there and not make it any worse.”
Some organizations are so convinced that health care legislation is a foregone conclusion that they have started working on a post-reform landscape.
Mark Merritt, president of the Pharmaceutical Care Management Association, for example, is already trying to figure out how best to make the health care changes work once the measure becomes law.
“Our advice is being sought out by policymakers to make sure the rollout of the reform goes well,” Merritt said.
Playing Favorites
Most business groups favor a final version that is closer to the Senate bill, which places fewer mandates on employers than its House counterpart and does not include the public insurance option.
But Austin said her organization’s top priority is now to press lawmakers to strike one provision slipped into the Senate version that would slap financial penalties on construction firms that employ five workers or more but do not provide health insurance. In other sectors, businesses with 50 or more employees would face the penalties. The measure was pushed by labor unions, which argued that without it most small construction firms would not offer health insurance.
However, business groups and homebuilders say it would place an onerous financial burden on construction firms.
The health insurance industry, led by America’s Health Insurance Plans, has also been critical of the Democratic reforms, claiming they would increase insurance costs for customers.
But AHIP spokesman Robert Zirkelbach said the industry is now seeking changes in the legislation that would make it less disruptive to consumers — such as changing implementation dates so that financial penalties don’t kick in before new benefits do.
Others in the health industry who have been more supportive of the health care efforts are banking on getting a more receptive hearing from staffers and lawmakers on the Hill.
Chip Kahn, president of the Federation of American Hospitals, said he hoped his organization “would have some influence because we were at the table early.”
“I’m hoping our concerns will be their concerns because we were able to invest ourselves early,” he said.
Hospitals reached an agreement last July with Senate leaders and President Barack Obama to contribute $155 billion over 10 years in savings as part of the health care overhaul effort.
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