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Healthcare lobbyists prepare for frenzy
Healthcare lobbying is about to shift into overdrive in Washington.
With Republicans moving full-speed ahead with the repeal of ObamaCare, lobbyists on K Street are scrambling to come up with ways to influence the result.
Few in the healthcare space expected President-elect Donald Trump's election, and they are now playing catch-up as Republicans consider sweeping changes to the healthcare system that could rival the overhaul that Democrats passed in 2010.
"My sense is that the confusion on the administration side has bled into the legislative side for some associations that did not expect this or did not plan for this," said Jeff Myers, the CEO of Medicaid Health Plans of America.
His group has been laser-focused for the better part of a year and a half on talking to lawmakers about how to reform Medicaid, which represents a growing portion of state and federal budgets - something that Republicans are likely to include in their repeal and replace legislation.
"We're not sitting on our hands," he said.
While the process of repealing ObamaCare is scheduled to begin this week in the Senate, the debate about how to replace it is nowhere near settled.
With so much uncertainty surrounding the Republican plan, some of the most influential healthcare groups are keeping their powder dry - though they are beginning to make their case for specific proposals.
America's Health Insurance Plans, for instance, has urged Congress to maintain the subsidies under ObamaCare that help people purchase insurance.
The American Hospital Association, meanwhile, is pressing Republicans not to move forward with a repeal bill until there is legislation to replace it.
When asked about its priorities in the impending budget resolution and how it would make them happen, the Pharmaceutical Research and Manufacturers of America told The Hill that it had no comment.
One early indication that deal-making is still underway on Capitol Hill: Key GOP figures have not yet come to K Street asking for support on any given measure, one industry source told The Hill. That step would typically be taken when they have settled on a path forward.
Still, Republican lawmakers appear poised to repeal much of the healthcare law over the coming weeks, including many of its taxes, the individual mandate to have insurance and the federal subsidies for low-income individuals to obtain coverage.
Some lobbyists are pushing Capitol Hill to address very specific tax measures in the Affordable Care Act - including repealing the healthcare tax imposed on insurance companies every year.
The Chamber of Commerce is part of the Stop the HIT Coalition, which aims to nix ObamaCare's health insurance tax. The coalition also includes retailers, manufacturers, franchises, florists, convenience stories and many other industries.
"The feeling among the industry is, if you look at the health insurance tax, this is an easy deliverable that Republicans can get behind and pass right away," said one individual in the insurance industry who is not authorized to speak on the record.
"With that huge tax cut, you could make the argument demonstrably that it would lower premiums - which is one of the promises they made in the last eight years.
"The smartest thing they could do is [label] the taxes and individual mandate [as] 'ObamaCare.' ... If you got rid of the mandate, you got rid of the taxes - [lawmakers can say], 'We gutted ObamaCare ... now we can focus about bringing patient-focused reforms to make the health system work better.' "
The Chamber has launched an ad campaign against the health insurance tax, but also opposes other taxes under ObamaCare, including the "Cadillac tax" on generous plans and the excise tax on medical devices.
AdvaMed, an organization representing medical device manufacturers, is continuing its push for repeal of the 2.3 percent tax on medical devices, which helps fund ObamaCare. Repealing that tax has drawn broad support from Democrats in the past.
"It's important to remind lawmakers that this is not a foregone conclusion" that the medical device tax will be repealed, said Greg Crist, AdvaMed's executive vice president of public affairs. "If it's believed to be that way ... then it may go down on the priority list. It runs the risk of slipping."
Groups seeking to protect the broad aspects of the Affordable Care Act are planning their own fierce lobbying efforts.
Two liberal coalitions - the Alliance for Healthcare Security and the Protect Our Care Coalition - are seeking to slow down and ultimately stop the Republican effort to roll back healthcare reform.
The two groups have some overlapping members, but the Alliance for Healthcare Security also includes the Alliance for Retired Americans, the American Medical Student Association, the Network for Patient Advocacy and the Medicare Rights Center.
Protect Our Care is composed of liberal advocacy groups, such as FamiliesUSA and the Center for Budget and Policy Priorities, labor groups like the Service Employees International Union and the liberal think tank the Center for American Progress (CAP).
"Each and every day that we delay the ultimate vote is a small victory because we have more time for more and more doubts to surface, for more and more stakeholders to come out against the repeal and delay strategy," said Topher Spiro, the vice president for health policy at CAP.
Spiro said that CAP and its partners are focused on "throwing as many wrenches into the works to delay the debate so that all of these concerns can be heard."
The organization is pushing Democratic members of the Senate to offer as many amendments - potentially hundreds each - to the budget resolution to keep the ObamaCare debate going, potentially, for days.
As part of the effort, CAP is finding individuals with personal stories about how a repeal of ObamaCare would affect them. After a vetting process, the group is setting those people up with a Democratic senator who can put forward an amendment related to their stories.
Spiro is so confident about the effort that he said CAP has not even formed a contingency plan for Republicans successfully repealing ObamaCare.
"I'm going to be honest, we're not even thinking about that. There's an assumption that it's inevitable that they'll be able to pass repeal," he said. "There are signs of growing cracks, and it's yet to be seen whether they're real cracks or how big they are. I don't think anyone should be giving up."
- This post was updated at 2:10 p.m.