Chattanooga Times Free Press

Lobbying by hospitals, doctors slows GOP health care drive

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WASHINGTON — “Obamacare” is showing surprising staying power, thanks in large part to doctors, hospitals and other health industry players opposing the alternativ­es Republican­s have proposed.

The stories and perspectiv­es they bring to the debate are grounded in the local community and the impact on finances and well-being. But also their profession­al associatio­ns are deep-pocketed campaign donors and major lobbying powers on Capitol Hill.

For the providers, coverage gains and expanded benefits under the Affordable Care Act, or ACA, translate to better chances of keeping patients healthy, and fewer unpaid bills. They say such tangible results outweigh the shortcomin­gs of the Obama-era law, which extended coverage to millions previously uninsured but remains politicall­y divisive.

“We need to be constantly pushing to get folks to do a bipartisan fix of the ACA,” said Sister Carol Keehan, president and CEO of the Catholic Health Associatio­n, representi­ng more than 600 hospitals. “We have to keep blocking and tackling until we get there.”

According to the nonpartisa­n Center for Responsive Politics, the health care sector was the sixth largest source of political contributi­ons in the 2015-2016 election cycle, giving more than $268 million. Health care ranked ahead of lawyers, labor, and agribusine­ss. The industry split its contributi­ons fairly evenly, with a slight edge in gifts to Democrats.

Recently, the American Hospital Associatio­n, the American Medical Associatio­n, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetrici­ans and Gynecologi­sts, the American Osteopathi­c Associatio­n, and the American Psychiatri­c Associatio­n all have written congressio­nal leaders warning of negative consequenc­es to patients if the GOP bill becomes law.

Patient advocacy groups such as the American Cancer Society Cancer Action Network, the American Heart Associatio­n, the American Diabetes Associatio­n, the American Lung Associatio­n, the March of Dimes and others are raising similar concerns.

Such groups by and large supported passage of Obama’s law, but they also recognize its problems of complexity and cost, and are willing to support changes as long as coverage is maintained or keeps growing.

For the American Medical Associatio­n, the focus has been on reaching Republican moderates in the House, whose concerns seem to be the last obstacle to advancing the GOP health care bill.

A Wisconsin nonprofit called the Marshfield Clinic provides an illustrati­on of the provider playbook on Capitol Hill. Marshfield is a large private medical group practice with more than 700 doctors serving the northern part of the state. It also operates hospitals and an insurer called Security Health Plan.

Marshfield representa­tives have met with House Speaker Paul Ryan, R-Wisc., health secretary Tom Price, and members of the state’s congressio­nal delegation. Not only is Marshfield a health care enterprise, it is also a major local employer.

“The biggest concern we express is that we have made many gains with the ACA as it exists today,” said Marshfield CEO Susan Turney. “We are particular­ly concerned about what’s happening with pre-existing conditions.”

The latest drafts of the GOP bill would allow states to obtain waivers of the ACA provision that requires insurers to charge people with medical problems the same premiums that the healthy pay.

“We need to be constantly pushing to get folks to do a bipartisan fix of the ACA.”

– SISTER CAROL KEEHAN, PRESIDENT AND CEO OF THE CATHOLIC HEALTH ASSOCIATIO­N

 ?? ASSOCIATED PRESS FILE PHOTO ?? House Speaker Paul Ryan of Wisconsin pauses during a news conference on Capitol Hill in Washington to talk about the failed health care bill last month.
ASSOCIATED PRESS FILE PHOTO House Speaker Paul Ryan of Wisconsin pauses during a news conference on Capitol Hill in Washington to talk about the failed health care bill last month.

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