LHC in DC: The odds of tweaking Obamacare

Cooper on gridlock: ‘Many of my colleagues live in a fictional world’

Editor’s note: This is the second post from the Nashville Health Care Council’s 2016 Leadership Health Care Delegation to Washington. Click here for the first entry from this year’s visit.

With a rainy view of the White House in the background, 100 of Nashville’s emerging health care leaders convened at the rooftop level of the W Hotel in Washington, D.C., to participate in the second day of Leadership Health Care’s annual delegation to the nation’s capital.

Leading the morning’s sessions were Tennessee’s U.S. senators, Lamar Alexander and Bob Corker, who provided brief updates on what they’re working on in Congress before fielding questions from delegates. Next, Congressman Jim Cooper (D-TN) participated in a discussion with Richard Cowart, chairman of the Health Law and Public Policy Department at Baker Donelson, about a number of topics, including his career in politics, the Clinton Administration’s attempt to pass health care reform legislation in the ’90s, the Affordable Care Act and gridlock in Congress.

“Most want to have their cake and to eat it, too,” Cooper said of House Republicans, who are creating obstruction in the legislative body and struggling among themselves to pass a balanced budget because they don’t want to raise taxes or cut spending. “Many of my colleagues live in a fictional world. That doesn’t help a country be great.”

Delegates also heard from U.S. Congressman John Yarmuth (D-KY), who was among the legislators who helped draft the Affordable Care Act. He talked about the positive impact the law has had on his district and the state of Kentucky — which was among the states that expanded Medicaid — as well as difficulties that Democratic legislators face in strengthening it.

“I think the employer mandate could be tweaked,” he said, as an example. “But even if there’s broad bipartisan support for change, if we introduce the change, (the bill) will then be amended to be a full-fledged repeal of ACA.”

Republicans, Yarmuth added, have not introduced an alternative to the law because there isn’t one.

“There is no alternative to what we’re doing other than single-payer health care,” he said. “Either we go back to where we were, where insurance companies control everything, or we move forward to single-payer health care.”

To close the delegation, LHC heard from Jeff Cohen, executive vice president of public affairs for the Federation of American Hospitals, and Kate Spaziani, vice president of grants and federal relations for New York-Presbyterian Hospital, about some of the policy issues hospitals are watching this year. Also, Dr. Meena Seshamani, director of the Office of Health Reform in the Department of Health and Human Services, returned to the delegation to discuss ACA implementation to date as well as what’s yet to come.

“The fact that we enrolled 12.7 million people in marketplaces at the end of this open enrollment, and more importantly we reduced the uninsured to a historic low and have 20 million more people who have coverage, that is just an incredible accomplishment,” Seshamani said.

Looking ahead to the last year of the Obama administration, Seshamani said there will be a focus on helping those people who gained coverage understand how to use it to improve their health and continue to look at new health care delivery models to identify the structures that work best to improve patient health in a cost-effective way. And though Republicans campaigning for the presidency in 2016 continue to talk about repealing the Affordable Care Act, Seshamani said repeal would be a very difficult task.

“You’re talking about 20 million people who have gotten coverage, and to repeal that would be devastating not only to those 20 million people, but all the infrastructure that has been created, the business that has been created,” she said. “Now is that to say there’s nothing to be fixed? Of course not.”