Health industry groups have been encouraged that their input is being sought in the Senate bill to repeal and replace Obamacare, but some say that they are unhappy about ongoing closed-door meetings and a lack of details about how lawmakers will make changes to the healthcare system.
In May, various groups expressed exasperation when the House passed a repeal bill, the American Health Care Act, that they said largely left them out of the conversation. The bill also faced public disapproval and was passed without a final score from the Congressional Budget Office, which makes projections about uninsured rates and the cost to the federal government.
Stakes are high for members of the healthcare industry, which have come to rely on federal Obamacare payments and could suffer under a rocky transition to a new healthcare model. They also worry about disrupting patient care.
“I think the general sense is that the Senate has been much more open to input than the House was,” an industry source said.
Senate Finance Committee Chairman Orrin Hatch, R-Utah, sent a letter to a broad array of industry groups and officials in mid-May requesting input on a repeal-and-replace bill. He cited examples for groups to provide their recommendations, including on Medicaid, tax credits and stabilizing the Obamacare exchanges. “Moving forward, I believe it is vital to have input from key stakeholders that represent the interests of patients, providers, employers and thought leaders,” Hatch wrote. “Toward that end, I intend to establish an open and orderly process for the submission of information and recommendations.”
In their responses, industry groups thanked Hatch for asking for their input.
“We appreciate … your commitment to receiving input from a broad range of stakeholders as the Senate considers how to advance patient-centered health reforms,” wrote Marilyn Tavenner, president and CEO of America’s Health Insurance Plans, which represents insurers.
Letters have been sent to the Finance Committee and provided to the Washington Examiner from groups that represent hospitals, doctors and patients. They have raised concerns about various aspects of the House bill, including whether more people would become uninsured, whether plans would receive adequate funding from the federal government, whether people with pre-existing illnesses would continue to be covered, and whether lawmakers would carry out a planned restructuring of Medicaid.
“My observation is that it’s been much more consultative than the House bill,” said Ed Haislmaier, senior research fellow in health policy studies at the conservative Heritage Foundation, noting, as well, that drafting was beginning among the relevant committees rather than within leadership as the House bill was.
A Congressional Budget Office score released last week projected that if the American Health Care Act becomes law, 23 million more people would be uninsured by 2026 and that the federal government would spend $119 billion less.
Despite fears about those outcomes, various groups that voiced worries about the American Health Care Act also cited provisions in Obamacare they would like to see changed.
Dick Woodruff, senior vice president of federal advocacy for the American Cancer Action Network, the lobbying arm of the American Cancer Society, which submitted recommendations, said that initially it seemed the Senate would be more inclusive when it came to healthcare talks.
“Since then I wouldn’t say that there has been a lot of outreach from other folks in the Senate,” Woodruff said. “The more I read about this and the more time goes by it appears this process is going to be pretty closed.”
Senators have been meeting regularly behind closed doors to discuss what they would like to see included in a healthcare bill. At least one meeting with the Senate healthcare working group included a presentation by insurer Blue Cross Blue Shield. Some senators have willingly spoken with reporters after the meetings to provide information about what was discussed, but the bill’s text isn’t expected to be drafted until during the coming recess. Woodruff said he would like to see public hearings about the bill and more concrete information about what the Senate’s legislation would do.
That frustration was echoed by the Catholic Health Association of the United States.
“We believe that the Senate should consider any healthcare reform legislation in a bipartisan manner and through regular Senate order including open committee hearings and markups,” the group’s president and CEO, Sister Carol Keehan, said in an emailed statement. “The healthcare reform legislation approved by the House and under consideration in the Senate goes well beyond just reform of [Obamacare]. The legislation restructures, restricts and deeply cuts federal funding for the entire Medicaid program … without a single public hearing scheduled in the Senate. ”
Senators do not plan on taking up the House’s healthcare bill and are writing their own. Initially, various members said they didn’t have a target date for repealing Obamacare, but pressure has been mounting to pass a bill before the August recess.
Even without additional input, industry groups have other ways to make sure their stance is heard and to put pressure on senators.
“We remain committed to informing our members, elected officials and consumers about the harm of this bill through continued ads, grassroots activities and our upcoming lobby day on Capitol Hill with staff and volunteers who plan to visit senators from every state to express our opposition to the House bill,” David Certner, legislative counsel at AARP, said in an email.
The American Cancer Action Network is planning to call and drop by Senate offices.
“The senators are going to be hearing from the cancer community,” Woodruff said. “They are going to get the message loud and clear that legislation that brings back discrimination of people with pre-existing conditions will not stand.”
