Healthcare reform: Obama cut private deals with likely foes

President Obama struck agreements with insurers, doctors, drug companies, and hospitals to keep them from turning against healthcare reform. What are they?

(Page 5 of 5)

“The bills attempt to remedy a problem that does not exist,” AHIP president and CEO Karen Ignagni complained in a letter to Rep. John Conyers Jr. (D) of Michigan, who chairs the House Judiciary Committee.

Related stories

“Ending this cozy exemption is another way to strengthen consumer choice through a competitive marketplace,” countered Sen. Patrick Leahy (D) of Vermont, who chairs the Senate Judiciary Committee.

Is the full Congress bound by such corporate bargaining with the White House?

“I think the administration is pretty pleased at what they were able to accomplish, but I think Congress has to take a look at these deals and do what it thinks is right,” says freshman Sen. Benjamin Cardin (D) of Maryland.

If Congress were to undo the deals with key stakeholders, the corporate interests now funding pro-reform ads could reverse course and come out strong against a final bill. In 1994, health insurers spent $50 million to defeat the Clinton healthcare proposal, including the devastatingly effective “Harry and Louise” ads. (Harry: “They choose.” Louise: “We lose.”) PhRMA alone is reported to have a $150 million war chest to use for the healthcare-reform endgame.

But for now, principal stakeholders are angling to get the best deal they can through negotiation – some with the White House at their side.

The American Academy of Family Physicians is still pushing for a permanent fix for that Medicare formula for doctors. “Every physicians’ organization was very disappointed when that was not done” in the Senate, says Lori Heim, the AAFP’s board president.

The AAFP is also disappointed that its request for a 25 percent bonus payment for primary-care physicians is down to 5 percent in some versions of the legislation. But the potential gains from insuring 30 million more Americans, she says, trump the disappointments.

“We have not had anything that says this is a no-go. We want to continue the discussion, but there need to be principles,” she adds.

Prospects for healthcare legislation turn on whether such groups stay with reform, even if agreements unravel, says Brookings’ Mr. Aaron, a longtime analyst of healthcare politics. “If you move into a psychological mode where people are saying, ‘I really don’t like this,’ but they’re trying to find ways they can live with the bill, rather than saying, ‘If I don’t get this, I’m not on board’ – that’s a big difference with 1994.”

----