PR and Obamacare: Where We’ve Been, Where We’re Headed
Among the fiercest political struggles this year has been the battle over whether to repeal and replace President Obama’s signature health care law, the Affordable Care Act, otherwise known as Obamacare.
That battle seemed to be over, at least for a time, when Senate Republicans failed to pass their “skinny repeal” legislation on July 28. But as the saying goes, “it ain’t over until it’s over.”
For seven years, Republicans have pledged to repeal the ACA. Having won the White House and maintained their majorities in both houses of Congress in 2016, they seemed well-positioned this year to follow through on that promise.
Back in January, when Washington state’s health care industry leaders and policy makers gathered at the annual State of Reform conference in Sea-Tac, a swift repeal of the ACA seemed a foregone conclusion. Conference keynoter James Capretta, a health policy expert at the American Enterprise Institute, told the gathering that change was definitely coming – Obamacare would be repealed. “The only question,” he said, “is how and in what context.”
Seven months later, Republican efforts to repeal and replace Obamacare ground to a halt in the Senate.
Where this goes next is anyone’s guess. But looking back on events from the past several months, our health and life sciences practice team here at Fearey offers a few observations.
Health care groups found their voice
Groups that represent doctors, hospitals, insurers and patients have long said that Obamacare is not a perfect law and that its flaws need to be fixed. That said, it was clear they were not on-board with a complete overhaul along the lines that Republicans were proposing.
After the House passed a repeal-and-replace bill, a broad coalition of health care organizations came out forcefully against Sen. McConnell’s Better Care Reconciliation Act. They ranged from the American Medical Association, the American Hospital Association and AARP to a host of other patient advocacy groups and even health insurers, including the Blue Cross Blue Shield Association and America’s Health Insurance Plans.
Here in Washington state, we saw a similar effort, with health care associations and executives expressing strong concerns about the BRCA and joining together to amplify their message. In July, the CEOs of the Washington State Medical Association, Washington State Hospital Association and Community Health Plan of Washington came together to pen an op-ed underscoring that the Republican bill would dramatically worsen health care and “make losers of all of us.”
Hospital executives also spoke out about the harsh impact that the Senate GOP bill would have on their ability to deliver services. Virginia Mason CEO Gary Kaplan noted in an interview with PSBJ that the GOP plan seemed like a “throwback” to a time when millions more people were uninsured, and many patients had to resort to using emergency departments as their main source of medical care.
Communication to the public hits a low point
Months of public deliberation and debate went into crafting the Affordable Care Act. But this year’s efforts to repeal and replace the ACA were marked by secrecy, misrepresentation and mixed messages.
Veteran health care policy reporter Julie Rovner of Kaiser Health News, who has covered the beat since 1986, called the “extreme secrecy” involved in developing the Republican health-care bill “a situation without precedent, at least in creating health law.”
The problem was not only secrecy, wrote fellow health care policy reporter Sarah Kliff of Vox. It was also “lying” by the Administration about its health care bill. Kliff noted, for example, that when Health and Human Services (HHS) Secretary Tom Price claimed in May that Americans would “absolutely not” lose Medicaid coverage under the House-passed bill, his statement was directly at odds with the Congressional Budget Office’s estimate that the bill would cause 24 million people to lose health insurance coverage by 2026, including millions that would lose Medicaid coverage.
The campaign to undermine Obamacare continues
Following the Senate vote, President Trump sent mixed signals about his intentions, saying on the one hand that congressional Republicans should push forward with a quick repeal and on the other hand that he intended to “let Obamacare fail” to force Democrats to negotiate.
In another notable twist, it was revealed that the Trump administration had used funds intended to encourage enrollment in the ACA for the opposite purpose: to discourage enrollment and undermine support for the ACA.
The Daily Beast first reported that HHS had launched a PR campaign against the ACA that included a series of testimonial videos featuring individuals claiming to have been harmed by Obamacare. In addition, HHS’s website had removed and altered information about the ACA.
Meanwhile, patients, health care providers and insurers are waiting to see what comes next.
In a refreshing turn toward bipartisanship, the Senate Health, Education, Labor and Pensions Committee has scheduled hearings in September to look at ideas for stabilizing the individual insurance markets—an aim that seems to have broad support.
In the weeks ahead, look for health care groups to be honing their message on just what needs to be done on that front.
Stay tuned for more insights from our Health Care + Life Science team.