Health­care on the de­fense at DNC

Af­ter lis­ten­ing to days of re­form bash­ing, ex­pect loy­al­ists to fight back hard

Modern Healthcare - - FRONT PAGE - Rich Daly

The po­lit­i­cal winds are push­ing health­care re­form to the top of the agenda this week in Char­lotte, N.C., as the Demo­cratic faith­ful gather there for the Demo­cratic Na­tional Con­ven­tion. The DNC is expected to fea­ture speech af­ter speech by lead­ing Democrats al­ter­nately tout­ing the 2010 fed­eral health­care over­haul and blast­ing Medi­care and Med­i­caid re­form pro­pos­als from Republicans. Al­though Obama cam­paign or­ga­niz­ers were mum about the ex­tent of the health­care fo­cus, ob­servers expected it will only grow fol­low­ing a Repub­li­can Na­tional Con­ven­tion last week that fea­tured a thor­ough thrash­ing of the Pa­tient Pro­tec­tion and Af­ford­able Care Act (See story, p. 10).

“My sense is yes, it will be a sig­nif­i­cant is­sue and was be­fore the Republicans started to talk about it in the last two days,” Meghan Fine­gan, a spokes­woman for the Ser­vice Em­ploy­ees In­ter­na­tional Union, said about the promi­nence of health­care poli­cies at the Demo­cratic con­ven­tion.

The pre-elec­tion gath­er­ing of the Demo­cratic faith­ful will fea­ture many of the lead­ing gu­ber­na­to­rial and con­gres­sional voices on health­care, as well as Pres­i­dent Barack Obama, for whom the Af­ford­able Care Act is seen as a defin­ing do­mes­tic pol­icy achieve­ment (See chart, p. 9).

How­ever, many of the provider groups that were crit­i­cal to that law’s en­act­ment will be ab­sent. That marks a change for some groups from pre­vi­ous con­ven­tions and has raised some eye­brows be­cause the na­tional news cov­er­age could present an op­por­tu­nity to ed­u­cate the pub­lic about a law that is still op­posed 47.9%-42.1%, ac­cord­ing to the Aug. 29 RealClearPol­i­tics poll of polls.

“If you’re one of those spe­cial­ties that wants this law to move for­ward in im­ple­men­ta­tion, you ab­so­lutely have to be out front and sup­port it,” said Julius Hob­son, for­mer lob­by­ist for the Amer­i­can Med­i­cal As­so­ci­a­tion. And that level of sup­port would en­tail ex­plain­ing the many pro­vi­sions of the law—both pop­u­lar and con­tro­ver­sial—to the me­dia cov­er­ing the na­tional con­ven­tions, said Hob­son, now a se­nior pol­icy ad­viser in the Wash­ing­ton of­fice of the law firm Polsinelli Shughart.

The AMA was one of the provider groups that led the con­gres­sional push to nar­rowly en­act the health­care over­haul af­ter a year­long pitched leg­isla­tive bat­tle. But that group is one of sev­eral provider groups that are sit­ting this con­ven­tion out, de­spite reg­u­larly send­ing rep­re­sen­ta­tives in pre­vi­ous years. An AMA spokes­woman de­clined to com­ment on why the group opted out of at­tend­ing this year.

An­other provider group that was key to the law’s en­act­ment but is duck­ing the con­ven­tions this year is the Catholic Health As­so­ci­a­tion, the largest solely not-for-profit hospi­tal as­so­ci­a­tion in the coun­try. The CHA’s late sup­port for the Af­ford­able Care Act was seen as crit­i­cal to the last-minute switch in fa­vor of the leg­is­la­tion by a group of Catholic Democrats, who al­lowed it to clear the House by seven votes. But the provider group de­cided against at­tend­ing this year, de­spite send­ing rep­re­sen­ta­tives to the 2008 Demo­cratic con­ven­tion.

CHA spokesman Fred Cae­sar said the or­ga­ni­za­tion de­cided “the con­ven­tions are not the forum that will make a dif­fer­ence.” In­stead, the group has sought to ed­u­cate the pub­lic about the law’s pro­vi­sions at smaller gath­er­ings na­tion­wide, such as an Aug. 17 speech to more than 100 Cleve­land community lead­ers by Sis­ter Carol Kee­han, pres­i­dent and CEO of the CHA.

To Vir­ginia Gray, Win­ston pro­fes­sor of po­lit­i­cal sci­ence at the Univer­sity of North Carolina at Chapel Hill, provider groups’ avoid­ance of the con­ven­tions is the lat­est ex­am­ple of their post-en­act­ment view of the law. “At the time of pas­sage, they did a lot of lob­by­ing and they ran a lot of ads,” Gray said. “So they felt like they did their part then; they prob­a­bly kind of feel like it’s the pres­i­dent’s job now.”

Back­ing up Obama and other elected Democrats this week will be some of the lib­eral ad­vo­cacy groups that pushed for en­act­ment and have funded many of the post-pas­sage pub­lic­ity cam­paigns sup­port­ing the law. Their sig­na­ture event, jointly spon­sored by the SEIU and Fam­i­lies USA and is set to fea­ture elected of­fi­cials and ad­vo­cacy group lead­ers, is touted as a cel­e­bra­tion of the law and bul­wark against a Repub­li­can pres­i­den­tial ticket that has pledged to re­peal it.

For their part, the ad­vo­cacy groups back­ing the health­care law were un­der­stand­ing of provider ad­vo­cates’ ret­i­cence to pro­mote the law to a skep­ti­cal pub­lic. “For each of these or­ga­ni­za­tions, they of­ten bal­ance con­sid­er­a­tions about their re­la­tion­ships to lead­ers in both par­ties,” said Ron Pol­lack, ex­ec­u­tive di­rec­tor of Fam­i­lies USA.

Republicans also are expected to have a phys­i­cal pres­ence in the city sim­i­lar to the Democrats’ “war room” last week in Tampa, Fla., but the de­tails were not com­plete by dead­line.


As Democrats de­scend on the Time Warner Ca­ble Arena for their con­ven­tion, provider groups will be no­tice­ably ab­sent.

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