Reform imminent, near-term changes are not
With a broad health overhaul bill in its final stages on Capitol Hill and passage likely, provider groups say they are preparing for a year that is at once different and yet strikingly similar to years past.
If 2009 was dominated by congressional efforts to shape the massive reform bill, then 2010 will be the year that the industry begins to see where the chips will fall.
While both the House and Senate have passed their own bills, Congress has yet to officially meld the two together. So even though the gen- eral contents of the 2,000-page legislative package are known, “It’s going to take months and months to figure out really what it all means,” says W. Reyn Archer III, managing director of the healthcare practice at Burson-Marsteller, a public affairs company.
An overworked Congress is pushing to have a final bill ready for President Barack Obama to sign into law possibly later this month—just before he delivers the annual State of the Union address. But longtime policy observers in Washington say that it’s just the beginning of what could be a protracted battle to try to steer the implementation process. “The job is really to let the dust settle and then begin to evaluate what some of the egregious things are,” Archer says.
The idea is to avoid what lawmakers and stakeholders call “unintended consequences.” For the lobbying community, it’s expected to be a full-time job this year.
Complicating matters, the all-encompassing nature of the reform bill has sucked up most of Congress’ legislative resources. Other opportunities to introduce new measures to make other changes to the healthcare system likely won’t surface in 2010.
Health reform 2.0
Richard Pollack, executive vice president at the American Hospital Association, also notes the need to help further shape the bill. “Legislative corrections are inevitable, and fix-its are inevitable,” he says. “If you want to call this healthcare reform 1.0, then there will be a 2.0.”
Pollack says he expects the focus this year to be on how newly created programs—such as the reform package’s insurance exchange and the dozens of pilot programs—play out. “There is a humongous amount of work associated with how reform gets implemented in terms of regulatory design,” he says, adding that much of that work gets done at the agency level rather than on Capitol Hill.
One area, however, that hospital groups will track is immigration reform, which could prove nearly as daunting to lawmakers as the reform bill. Both the House and Senate bills have the potential to leave millions of illegal immigrants uninsured, which creates a financial hit to hospitals that have to treat them.
“We are creating a health reform (bill) that extends coverage to a lot of people, but we’re still leaving out a lot of folks,” Pollack says.
Pollack adds that the AHA would work with