Tracking Health Care Reform

Week of July 9th on Capitol Hill      
      by Christina Sochacki R.N., J.D.

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[As published by the Council for Affordable Health Covearge - CAHC.net]

Healthcare Law Repeal
In the wake of the Supreme Court’s decision to uphold the constitutionality of the individual mandate, the House Ways and Means Committee held a hearing on the implications of the ruling. On Tuesday and Wednesday of last week, the House debated repeal of the law, which resulted in passage of H.R. 6079, the “Repeal of Obamacare Act”, by a vote of 244 to 185. Five Democrats voted to repeal the law: Dan Boren of Oklahoma; Larry Kissell of North Carolina; Jim Matheson of Utah, Mike McIntyre of North Carolina; and Mike Ross of Arkansas.

Despite the success of this bill in the House, the Senate is much less likely to entertain such a vote. Even if the bill is able to muster enough votes from the Senate, which has a Democrat majority, the White House has threatened a veto. The vote, however, will continue the Republican rally efforts for the November elections.

H.R. 6079 was the second House vote in the 112th Congress to overturn the health care law. The House passed the earlier repeal bill, H.R.2, “Repealing the Job-Killing Health Care Law Act”, with a vote of 245-189, on Jan. 19, 2011.

Overall, today’s vote is the 33^rd vote in this Congress to repeal, dismantle or defund all or parts of the law, as counted by Majority Whip Kevin McCarthy. To date, there have been 1,218 scheduled hearings related to the health care industry in 2012 and 152 scheduled hearings related to the health care industry in the last 30 Days.


Healthcare Law Hearings:
The House Oversight and Government Reform Committee held two hearings on July 10th on the implications of the Supreme Court decision on the Affordable Care Act. The first explored the impact of the PPACA on job creation and the economy. The second examined the impact the PPACA on doctors and patients. The House Ways And Means Committee also held a hearing on July 10^th concerning the constitutionality of the individual mandate and the implications of the ruling on Congress’ taxing authority under the Tax Clause of the Constitution.

Chairman Darrell Issa’s opening remarks during the hearing, “Examining the Impact of Obamacare on Job Creators and the Economy,” noted,“[w]e know that Obamacare makes labor more expensive, it requires employers of at least 50 full-time workers to offer a more expensive selected and mandated government health care -- insure or pay an insurance tax of $2,000 or $3,000 per worker. The law will discourage 63,000 businesses with between 40 and 59 workers from expanding.” Issa further noted, “[a]lthough some of the cost increases will be passed on to customers, most will be passed on to workers in the form of lower wages or lost job opportunities.”

In the Oversight Subcommittee on Health Care, District of Columbia, Census and the National Archives hearing, “Examining the Impact of Obamacare on Doctors and Patients,” Chairman Rep. Trey Gowdy (R-SC) noted, “the Affordable Care Act significantly increases government's role in health care. For example, the law creates 159 new agencies, boards and committees to control how physicians do their jobs.” Gowdy further noted that the Affordable Care Act “has already generated over 12,000 pages and regulations and administrative requirements that only serve to distract and delay a doctor's primary objective, which is to provide care to patients.” This may compound patient access to care. For example, according to the American Association of Medical Colleges, there will be a doctor shortage of 124,000 to 159,000 physicians in the US by 2025.

During the House Ways And Means Committee held a hearing, “Constitutionality of the Individual Mandate”, Chairman Dave Camp (R-MI) noted, “in light of the Court's ruling, Congress now has the broad power to levy taxes far beyond the historic understanding of raising revenue.” Camp further noted, “the power to tax has never been used to coerce people who do not purchase a specific product or service. This is the first indirect tax on inactivity in American history.


Looking to the Future – Repeal & Replace
The Republican Leadership is vowing that, should Republicans take charge of the Senate next year, they will use the budget reconciliation process, the same procedure Democrats used to approve the law in 2010, to repeal the health care reform law. With the law now considered a tax, a simple majority vote would allow measures to go forward.

Dr. Tom Price, Chairman, House Republican Policy Committee and Dr. John Barrasso, Chairman, Senate republican Policy Committee, recently participated in a panel discussion hosted by the American Action Network and Crossroads GPS. Dr. Price explained that, in repealing and replacing Obamacare, any alternative law must focus on the cost of care. Dr. Price indicated pro-market alternatives to the PPACA would be introduced over the next few months to lower the cost of health care.

Additionally, Dr. Price suggested that individuals should be able to shop around and own their insurance policy, like home insurance. Dr. Barrasso and Dr. Price argued that health insurance should be like a 401(K), retirement plan, which individuals take with them no matter where they work or if they are employed. Any replacement law, they argued, would need more price and quality transparency, and promote patients as consumers who are empowered to question whether certain tests or procedures are necessary.


Up Next for CAHC
Legislators on both sides of the isle are discussing ways to address the affordability of healthcare within the context of the PPACA or through alternative proposals. Currently, the Republican Study Committee has compiled a list of 219 bills that address repeal and individual pieces of a health care overhaul. The moment is ripe for reforms that address price, utilization and quality, including aggressive adoption of information technology; streamlining clinical workflows; promoting medication adherence; changing PPACA’s rules to allow for more employer flexibility; and, most importantly, mitigating the detrimental effects of uncompetitive markets. CAHC will continue to work with all members of Congress to help ensure costs are lowered and coverage is more affordable.


— Christina Sochacki, R.N., J.D. is the Vice President of Legal and Government Affairs at the Council for Affordable Health Coverage.