Lobbying groups prepare for reconciliation process, step up fight on bill features

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Lobbyists are beginning to consider how their clients would fare if health reform moves to a reconciliation process to pass legislation, Roll Call reports.

"As the health care debate has grown increasingly partisan, lobbyists say they are taking more seriously the looming possibility of having many reforms added to reconciliation. 'I think almost everyone looks at reconciliation as a last resort,' said John Rother, executive vice president of policy and strategy for the seniors' lobby AARP. 'But we haven't made a lot of progress. Patience is running thin.'" A bill passed by reconciliation would need only 51 Senate votes instead of the filibuster-proof usual 60.

"On the reconciliation track, lobbyists say they are attempting to navigate Senate rules and procedures to figure out what health care items could go - and could not go - with reconciliation. In order to be included in the budget bill, policy measures would have to be scorable by the Congressional Budget Office and would be subject to Senate precedents and the Byrd rule, which prohibits 'extraneous matter' on reconciliation bills."

"The key question is what would be included under reconciliation and what would be the status of pre-existing industry deals, such as one struck with pharmaceutical companies that would reportedly raise $80 billion in revenue over 10 years or one with hospitals that agreed to take a $155 billion hit over a decade. Lobbyists with pharmaceutical and hospital clients said it's unclear for now what would happen to those deals, especially because budget reconciliation rules cover only a five-year period" (Ackley, 7/13).

Other lobbyists are concerned that the pharmaceutical and hospital cuts won't cut costs at all, but could make the problem worse, the Los Angeles Times reports: "Both (Senate and House) bills would create a government insurance program that senior Democrats say could pressure providers to lower costs. What is missing, critics contend, are bolder initiatives in the existing Medicare and Medicaid programs to reward doctors and hospitals that become more efficient -- and cut federal payments to those that do not. … Even the recent agreement between hospitals and the administration to cut federal payments to hospitals by $155 billion over the next decade does little to change the way providers are paid, said Mark McClellan, who headed the Centers for Medicare & Medicaid Services under the Bush administration. Nearly all these projected savings would come from cuts in federal reimbursements, which critics fear could prompt hospitals to simply charge private insurers more" (Levey, 7/13).

Some groups still pushing include:

The National Retail Federation "is launching a broad attack" against Wal-Mart's endorsement of an employer mandate to cover employees, the Wall Street Journal reports: "The National Retail Federation plans to send an aggressively worded letter Monday to its members encouraging them to take a stand against Wal-Mart's backing of an employer-health-care mandate. The federation is the primary lobbyist for the retail industry, which comprises 1.6 million businesses and employs roughly one in five working Americans. Wal-Mart isn't a member of the group" (Bustillo and Adamy, 7/13).

The Biotech industry "is moving closer to victory" in regard to legislation addressing generic drug competition, according to another story from the Wall Street Journal: "The Senate Health, Education, Labor and Pensions Committee will be looking at a bill this week that would grant so-called biologic drugs -- those engineered from living cells -- made by companies like Amgen Inc. a total of 13½ years of intellectual-property protection, which is about twice the length of time proposed by the White House" (Mundy, 7/13).

Grassroots, pro-reform groups are making their opinions known, according to the Columbus Dispatch: "With health-care reform a top priority of the Obama administration, insurance companies, drug- and device-makers, hospitals, medical groups and others are vying for a say in the policymaking. But so are individuals such as (self-employed contractor David) Cress, who are working at a grass-roots level. (Because of his medical bills), (h)e was invited by ABC News to be in the audience a couple of weeks ago at a health-care forum at the White House that was hosted by President Barack Obama. Cress is collecting health-care stories from other people and sending them to members of Congress" (Hoholik, 7/11).

Even hip-hop performers are putting in their two cents, according to the Chicago Tribune: "You don't normally think of rap stars as having much to do with Washington's health care debate. … But, even rappers get older, if they're lucky. Bodies begin to give out, doctor bills begin to pile up and suddenly that health care debate hits home. 'Normally I find it kind of hard being a part of things like this,' said hip-hop artist Malik Taylor, better known as 'Phife' or 'Phife Dawg' from the Billboard award-winning rap group A Tribe Called Quest. True that. 'This' was a health care round table co-sponsored by the New York-based Hip-Hop Theater Festival, which is something that is in town this week besides Congress" (Page, 7/11).


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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