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If the law is overturned, hospitals, for example, may not have to forgo $155 billion in federal funding over a decade. Drugmakers may not have to extend more than $80 billion in discounts and fees to help pay for the legislation. Such players would also lose out on increased business from an expansion of the Medicaid programs and other coverage requirements that would bring as many as 32 million newly insured people into the fold.
Some health care providers might spend the summer trying to convince Congress to pass a package that reinstates the coverage expansion. If the court just strikes the “individual mandate,” the Obama administration and insurers may mount a high-profile effort to entice uninsured people to voluntarily enroll in plans.
All of that would play out against the backdrop of a presidential election, with the threat of $1.2 trillion in mandatory budget cuts on the horizon, making it tough for lobbyists to convince lawmakers to change their stance if it means adding to the deficit.
Meanwhile, corporations outside the health care industry are turning to their Washington lobbyists to help guide business decisions such as how to meet the law’s minimum coverage requirements or whether to drop their health care plan and send workers into newly created markets called “exchanges.” Lobbyists are urging their clients to slow-walk preparations for the new health care law but not to entirely halt them.
“Bottom line, it’s impossible to predict what could happen,” said Todd Weiss, a Republican lobbyist at SNR Denton, whose clients include PricewaterhouseCoopers LLP and the Genentech unit of the Swiss drug giant Roche Holding AG. “Because of that, I think most stakeholders will assume implementation unless told otherwise. If that day comes, so be it and everyone will respond accordingly.”
That strategy may not work as well for health care providers that will be at a competitive disadvantage if they simply wait for a court ruling, said Stephen Cooper, a lobbyist at K&L Gates who represents health plans, including Tufts Health Plan and a coalition of church plans.
They will also have to figure out what to do with the benefits that are already in effect. Health insurers have already been meeting with lawmakers to discuss what would happen if the individual mandate is struck but safeguards guaranteeing coverage for those with pre-existing conditions remain, Cooper said. They have come up with a number of proposals, including one that would impose a financial penalty on anyone that delays getting coverage until he or she is sick.
Thorn Run’s next stakeholder conference call will focus on activity in the state legislatures, where preparations for administering the Medicaid expansion and the new insurance exchanges have been put on hold until after the court’s ruling.
“Don’t spend a lot of money on us right now because I can’t tell you what’s happening. There are too many unknowns,” Cooper said.
But, he added, one thing seems certain: Any outcome “will make lobbyists pretty rich.”