POL­I­TICS: Re­peal­ing pre­form was hot topic at the Repub­li­can con­ven­tion

GOP lead­ers em­pha­size the need to re­peal ACA

Modern Healthcare - - FRONT PAGE - Jes­sica Zig­mond

Pres­i­dent Barack Obama’s sig­na­ture do­mes­tic pol­icy achieve­ment, the Pa­tient Pro­tec­tion and Af­ford­able Care Act, took a heavy beat­ing last week at the Repub­li­can Na­tional Con­ven­tion in Tampa, Fla. But those de­liv­er­ing the hard­est blows weren’t the two politi­cians whose names will top the GOP ticket in Novem­ber.

In ac­cept­ing his party’s nom­i­na­tion for pres­i­dent, for­mer Mas­sachusetts Gov. Mitt Rom­ney barely men­tioned health­care in his nearly hour­long speech at the Tampa Bay Times Forum. A night ear­lier, vice pres­i­den­tial nom­i­nee Rep. Paul Ryan (R-Wis.) drew ap­plause when he panned the Af­ford­able Care Act in his ac­cep­tance speech. But his re­marks were al­most im­me­di­ately crit­i­cized by pun­dits and Democrats for pro­vid­ing a mis­lead­ing de­pic­tion of the re­form law’s Medi­care pro­vi­sions.

Mean­while, the harsh­est criticism for the Af­ford­able Care Act came from other Repub­li­can law­mak­ers at­tend­ing the con­ven­tion who re­peated the same mes­sage throughout the week: The en­tire health­care re­form law must go.

One of those politi­cians was Sen. John Barrasso (R-Wyo.), an or­tho­pe­dic sur­geon who be­gan the week rail­ing against the 2010 law when he served as the key­note speaker at a health­care pol­icy lun­cheon in Tampa spon­sored by the Amer­i­can Ac­tion Forum, a Wash­ing­ton-based con­ser­va­tive think tank.

Barrasso said he has de­nounced the law more than 70 times on the Se­nate floor. One of the big­gest flaws in the law, he said, is that it pro­vides “17 mil­lion peo­ple with a Med­i­caid card but puts no money into the law that can train doc­tors, nurse prac­ti­tion­ers, physi­cian as­sis­tants, nurses and oth­ers” who would care for those pa­tients. On the night be­fore the con­ven­tion started, Barrasso told Mod­ern Health­care that he be­lieves it’s pos­si­ble for Congress to re­peal the Af­ford­able Care Act de­spite the U.S. Supreme Court’s rul­ing this sum­mer that the law is con­sti­tu­tional.

“With a new pres­i­dent and con­trol of the Se­nate by the Repub­li­can Party, it will take place,” Barrasso said of re­peal leg­is­la­tion, which has passed twice in the Repub­li­can-led House of Rep­re­sen­ta­tives but has gone nowhere in the Demo­cratic-con­trolled up­per cham­ber.

“Mitt Rom­ney has said he would sign that. We’re go­ing to use rec­on­cil­i­a­tion to re­peal it in the Se­nate, but we need the out­come of this elec­tion, which re­ally makes a dif­fer­ence,” he said. “The Supreme Court may have ruled that it’s not un­con­sti­tu­tional, but this health­care law is still un­work­able; it is very un­pop­u­lar, and for our na­tion, it’s un­af­ford­able.”

The rec­on­cil­i­a­tion Barrasso men­tioned would al­low the Se­nate to make changes to the cur­rent law through a bud­getary process. Rep. Tom Price (R-Ga.), an­other or­tho­pe­dic sur­geon on Capi­tol Hill, sim­i­larly called for re­peal when he served as a pan­elist at a health pol­icy break­fast dis­cus­sion in Tampa.

“From a re­peal stand­point, we un­der­stand that the bill that was put into law now doesn’t work,” Price said. “It doesn’t work for any­body in the sys­tem—whether it’s pa­tients or doc­tors or em­ploy­ers or em­ploy­ees or state gov­ern­ments or the fed­eral gov­ern­ment,” he added. “What is a must is that it has to be re­pealed.”

Re­peal­ing the law is an ob­jec­tive that Rom­ney men­tioned in his ac­cep­tance speech Aug. 30 and that the GOP adopted in its of­fi­cial plat­form on the con­ven­tion’s first day. That agenda also pro­poses a mas­sive re­design of the Medi­care pro­gram that would al­low pa­tients to choose be­tween tra­di­tional fee-for-ser­vice Medi­care and pri­vate health in­sur­ance plans.

As chair­man of the pow­er­ful House Bud­get Com­mit­tee, Ryan pro­posed this lat­ter con­cept—known as a pre­mium-sup­port model—in his bud­get pro­pos­als for fis­cal 2012 and 2013 that passed in the House but went nowhere in the Se­nate.

But while Ryan cer­tainly is one of Wash­ing­ton’s loud­est cheer­lead­ers for pre­mium sup­port, the Wis­con­sin Repub­li­can made no men­tion of it last week in his ac­cep­tance speech. In­stead, he tai­lored his Medi­care com­ments to fit with his criticism of the pres­i­dent and the re­form law.

“You see, even with all the hid­den taxes to pay for the health­care takeover, even with new taxes on nearly a mil­lion small busi­nesses, the plan­ners in Wash­ing­ton still didn’t have enough money,” Ryan said on Aug. 29 to an en­thu­si­as­tic crowd at the Tampa Bay Times Forum.

“They needed more. So, they just took it all away from Medi­care. Seven hun­dred and six­teen bil­lion dol­lars fun­neled out of Medi­care by Pres­i­dent Obama,” he added. “An obli­ga­tion we have to our par­ents and grand­par­ents is be­ing sac­ri­ficed—all to pay for a new en­ti­tle­ment we didn’t even ask for.

“The great­est threat to Medi­care is Oba­macare, and we’re go­ing to stop it,” Ryan said.

FactCheck.org, a project of the An­nen­berg Pub­lic Pol­icy Cen­ter, re­leased a re­port the day af­ter Ryan’s speech that noted about $415 bil­lion of those cuts will come in the form of re­duced Medi­care pay­ments to hos­pi­tals, not from re­cip­i­ents’ ben­e­fits. This also was a point that Rep. Chris Van Hollen (D-Md.), rank­ing mem­ber on the House Bud­get Com­mit­tee, em­pha­sized from a “war room” in Tampa set up by the Demo­cratic Na­tional Com­mit­tee and Obama for Amer­ica on the morn­ing of Ryan’s speech.

“Rom­ney would now re­store some of the over­pay­ments that Medi­care was mak­ing to pri­vate in­sur­ance com­pa­nies and oth­ers,” Van Hollen said af­ter a news con­fer­ence. “And since se­niors pay a share of the over­all cost of Medi­care through pre­mi­ums and co-pays, they will now have to pay more—right now.”

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While Rom­ney and Ryan men­tioned the ACA briefly in their speeches, other law­mak­ers spent the week heav­ily crit­i­ciz­ing it.

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