Shut Out by House GOP, Industry Pins Health Bill Hopes on Senate

(Bloomberg) — The health care world is gearing up for a lobbying offensive to persuade Republican U.S. senators to address their problems with H.R. 1628, an Affordable Care Act change bill replacement that was conceived in the House in a virtual vacuum.

Insurers, doctors, patient groups and most health care experts are pinning their hopes on the Senate being more receptive after House Republicans — led by Speaker Paul Ryan — deliberately avoided discussing their plans for the American Health Care Act bill with the main groups that would be affected by changing the 2010 law. House GOP lawmakers say they kept the process closed out of concern that interest groups might try to shape the bill in their favor.

(Related: Senate ACA Replacers May Tap Medicare Surtax and Net Investment Tax)

“Lord no!” said Rep. Phil Roe of Tennessee, co-chairman of the House Republican doctors’ caucus, making the case that some segments of the health industry benefited from the very regulations and paying customers created by the ACA. “They have a vested interest in keeping it around.”

Now, as GOP senators try to craft a repeal bill that can attract 50 votes, the industry won’t be left on the sidelines. Billions of dollars in U.S. health spending are at stake for hospitals, insurers and doctors who are worried by estimates that 24 million fewer Americans would be insured by 2026 under the House bill.

“I think initially there will be a lot more accessibility,” said Dick Woodruff, senior vice president of federal advocacy at the American Cancer Society’s lobbying arm, the Cancer Action Network. “I think the Senate process is going to be a lot more deliberative.”

‘No Formal Outreach’

Groups representing doctors also say that senators appear open to meeting with them.

“On the House side, there was no formal outreach, that I know of, by House leadership to sit down with us and hear our concerns or get our input before the bill was introduced,” said Bob Doherty, senior vice president of health policy and regulatory affairs at the American College of Physicians. “After, we did have repeated meetings with people in House leadership, the door was open and we expressed our concerns but it didn’t seem to do much good.”

“It is a little bit of a surprise to me,” Doherty added. “Health reform is so difficult. Getting people who take care of people engaged in the process and not actively opposed would seem to be smart policy as well as politically.”

The health care industry wants to protect coverage by preserving a Medicaid expansion instituted under the Affordable Care Act. Insurers have also called for increasing the financial help offered in the bill to Americans buying insurance in the individual market.

As chairman of the House Energy and Commerce Committee, Greg Walden of Oregon was one of the bill’s prime authors. He said he and his team regularly talk to industry players, but they didn’t want to rely on people who supported the ACA.

‘Different View’

“I spent a lot of time with the hospital association people,” he said, offering one example. “You know, they got a different view. But obviously the Medicaid cuts, and all of that, we talk to them about.”

Roe said, “The whole idea was not to come up with Obamacare again.”

A lobbyist for hospitals, who asked to remain anonymous, confirmed meeting with Walden though not with House leaders. When the bill text came out in early March, the details were a surprise, the lobbyist added.

America’s Health Insurance Plans, the insurers’ main lobby group, had also been working for months to sway lawmakers on the Affordable Care Act change legislation, but it also didn’t see the bill before it was released to the public, a person familiar with the group’s strategy said.

Indeed, the bill was kept away from most Republican lawmakers before its release, prompting the spectacle of Sen. Rand Paul, a Republican skeptic of the House plan, searching Capitol rooms for the bill with a trail of reporters following him.

‘Haphazardly Constructed’

Leading House moderate Charlie Dent of Pennsylvania complained that the final House measure passed May 4 was “haphazardly constructed and hastily considered.”

He isn’t alone: Senate Republicans are already promising to carve it up and build a better version.

Sen. Dean Heller, R-Nev. (Photo: Heller)

Woodruff said his Cancer Action Network plans to meet with members of the task force Senate Majority Leader Mitch McConnell helped assemble to lead his party’s efforts on the health bill.

The American Medical Association said in a letter to Senate leaders Monday that it’s ready to work with Congress on the bill, and that the measure shouldn’t weaken health coverage.