Health law repeal murky as groups press officials, target specific provisions

In an analysis, The New York Times, reports that while "Republicans have a big majority in the House, Democratic control of the Senate and the presidential veto power make repeal [of the health law] or major change impossible. [But] there is another reason. More than a few Republicans know that while the politics of trying to nitpick provisions and curb funding are appealing, any wholesale repeal of major provisions of the health care overhaul is likely to generate a backlash. Even the Republican-leaning electorate on Nov. 2 was evenly split on repealing Obamacare, the exit polls showed. And many of the major provisions of the bill command broad support or could expose critics and repeal advocates to embarrassing contradictions. …"

"To be sure, there are problems that could lend themselves to a bipartisan fix. Small businesses complain of too much red tape, some of which can be alleviated. Some Democrats even want to allow states to opt out of the individual mandate, though that would create enormous complications" (Hunt, 11/21).

Roll Call: Meanwhile, "Majority Leader-designate Eric Cantor said Saturday that Republicans' willingness to work with Democrats and the White House was conditional and that the party would quickly push through the House a full repeal of the health care reform bill that was passed earlier this year. The Virginia Republican was speaking at the 27th annual Donald W. Huffman Advance, a gathering of some 600 Virginia GOP leaders and activists" (Trygstad, 11/20).

NPR correspondent Julie Rovner says many in the health care industry don't want a repeal: "Well, it's most of the big players — hospitals groups, a lot of doctor groups, drug makers, employers, even health insurers. Which is not to say that they all love the law or that they don't want to see changes. But some of them, particularly health insurers, are agitating for bigger changes than others. But almost without exception, they say they'd rather work to make changes to this law than scrap it and start over" (Simon and Rovner, 11/20).

The Hill's Healthwatch blog: "Democrat Ron Wyden (Ore.) and Republican Scott Brown (Mass.) may have found a way to take the partisan venom out of the healthcare reform debate, according to some state officials and policy experts." The pair introduced legislation that would allow states to seek waivers from some of the health law's requirements "including federal regulations that Republicans have decried as an intrusion on the states — beginning in 2014, when most of the law's major provisions are scheduled to take effect." The bill would allow states to opt out of, among other things, the individual mandate. "The Wyden-Brown proposal is significant because it represents the first bipartisan proposal to alter the healthcare law since the midterm elections" (Pecquet, 11/22).

CQ HealthBeat: Meanwhile, state "officials anxious about the task of creating insurance exchanges under the health law got some relief this week: greater clarity about the steps involved. But any comfort they're feeling is probably quickly giving way to headaches about the size of the job. … A key point: states can construct an 'active purchaser' exchange that bargains with health plans for the best deal and excludes those offering lousy deals, or they can follow an 'open marketplace' model that basically posts plan offerings and leaves to marketplace forces rather than regulators the process of producing good deals. Republicans may tilt strongly toward the latter model in the many states in which they will wield greater influence over state lawmaking after the recent November elections" (Reichard, 11/19).

The Wall Street Journal reports on a forum it held with several major health care players, including Angela Braly, CEO of insurer WellPoint Inc; William Hawkins, CEO of Medtronic Inc.; Klaus Kleinfeld, CEO of Alcoa; and Risa Lavizzo-Mourey, CEO of the Robert Wood Johnson Foundation. The four talked about changing the incentives in the health system. Said Braly on delivery system reform: "This really gets to the fact that right now we have a fee-for-service payment system, so we pay for quantity rather than quality. And very importantly, we think we need to redesign the way in which we reimburse for health care. When we do that, we need to take into account the right time, so preventive care, hopefully; the right setting, which might be a hospice at the end of life, it might be a different setting altogether; the right team, so a coordinated, team-based approach to the way that health care is delivered; and the way we reimburse" (Landro, 11/22).

Bloomberg News/The (Fort Wayne, Ind.) Journal Gazette: Some pharmaceutical companies and their lobbyists are trying to get rid of a government panel in the health law that would try to control Medicare spending. "The presidentially appointed board has the ability to control drug prices by reducing the amount the federal Medicare program will pay for medicines, Bart Peterson, senior vice president of corporate affairs at Indianapolis-based Eli Lilly, said in a telephone interview. … The drug industry's endorsement of the health law included a promise to contribute $80 billion toward the overhaul, helping Democrats offset new spending in the bill and clearing the way for passage in March. Now manufacturers will need help from Republicans who take control of the House next year to weaken or eliminate part of the law" (Edney and Young, 11/22).