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April 10, 2014 at 08:57 AM
(Bloomberg) — Here’s the scenario: You run a trade association, and your corner of the health-care sector gets stuck with part of the bill for Obamacare. Naturally, you’d rather not pay that bill, so you start a campaign against it. You assemble a coalition of lawmakers from both parties to support your argument. You pay for studies. You write letters. You meet with officials.
What happens next? If you represent the insurance industry, and you’ve been fighting the law’s reduction in Medicare Advantage payments, you rack up a series of modest wins. If you represent the medical device industry, and you’ve been fighting the law’s excise tax on your products, you get bupkis.
The two situations aren’t perfectly analogous, of course. But they’re similar enough to raise the question: Why has one campaign succeeded and the other failed? A few differences in strategy stand out.
First, it helps to look for a way around Congress. Both the device tax and the cuts to Medicare Advantage payments were written into the law. The trade association for device makers, the Advanced Medical Technology Association, or AdvaMed, tried to fight the law head-on, pushing lawmakers to repeal the tax.
But that’s a high-risk strategy, as Congress isn’t passing much these days. The insurers’ association, America’s Health Insurance Plans, was more subtle. Rather than push to repeal the part of Obamacare that cut rates, insurers lobbied the government to offset those cuts with other money. This week, they succeeded, turning a 1.9 percent cut into a 0.4 percent increase — without changing the law.
To be sure, AdvaMed, with no equivalent regulatory fix to pursue, had a weaker hand to play. But that isn’t the only difference. AHIP’s second bright idea was making it easier for the Barack Obama administration to back down, by not framing their campaign as a challenge to the president’s signature achievement.
