Repeal effort is expected, but in the end, overhaul is likely to survive.
The election is less than a week old, and already proponents and opponents of President Obama's landmark health-care overhaul are working hard to protect and preserve it, or, as the Republicans have pledged, to repeal and replace it.
The election is less than a week old, and already proponents and opponents of President Obama's landmark health-care overhaul are working hard to protect and preserve it, or, as the Republicans have pledged, to repeal and replace it.
That means lot of heavy lifting in Washington for people like Christina Nyquist and Michael Strazzella.
Nyquist is vice president of public policy for government affairs for Aetna Inc., the huge national health insurer. Strazzella is vice president of federal relations for the Hospital & Healthsystem Association of Pennsylvania.
Long titles for a short job description - lobbyist.
"I predict the first bill in the House will be an all-out repeal" of the Patient Protection and Affordable Care Act, Strazzella said Wednesday in Philadelphia, talking to a room full of health-benefit administrators, brokers, and consultants.
"It will pass, and then it will never be heard of again," he said, noting, as others have, that the vote will be mostly symbolic for the House, newly dominated by Republicans. The Democratic majority in the Senate and President Obama will make sure the repeal effort is halted legislatively.
"Then we'll see the House start to pick apart various provisions," Strazzella said.
The audience at the Downtown Club in Center City had more than a passing interest.
As members of the Penjerdel Employee Benefits and Compensation Association, they manage or sell company health plans. They are the ones who must put the bill's provisions into practice in the workplace.
The two lobbyists were joined by Temple University risk-management professor Thomas Getzen, executive director of the International Health Economics Association.
Strazzella said the Republicans would nibble away at the edges of a key element of the legislation - the individual mandate requiring that everyone be insured.
It cannot be accomplished legislatively, so it will be accomplished on the funding side, Nyquist said, as Congress strips away the ability of federal agencies to enforce the law's provisions.
The GOP will also push for curbs on malpractice suits. "That's an easy deal that Obama could make that would allow [the Democrats] to pick up some political gains," Getzen said.
It is a sure bet, they said, that the GOP will be looking for ways to cut costs out of the health-care legislation. One likely target will be some of the quality initiatives, Strazzella said.
There will be pressure to reduce the subsidies given to people who cannot afford to buy coverage, they said.
With the legislation likely to be in the political crosshairs, both lobbyists hope their organizations can revisit some of the bill's provisions.
Strazzella would like to see changes in the rules involving reimbursements for readmissions; hospitals sometimes will not be paid by insurers if patients return to the hospital with the same problem. Strazzella said hospitals could not control how patients manage their recuperation when they are discharged.
Nyquist does not like the tax that insurers will have to pay on the policies they sell. "It doesn't make sense to have a tax that's ladled on if you are trying to make insurance affordable," she said.
All three panelists believed that the legislation would basically survive. In fact, Getzen said, economic trends might give it a boost just in time for the election in 2012.
"When inflation hits housing and food prices, it takes 36 months before it kicks in for health care," he said.
"Health reform is going to look good by 2012," Getzen said, "because inflation will be roaring through the rest of the economy."