Industry Insights

March 22, 2012

‘Everything is in play’ (originally published in Post Business blog)

‘Everything is in play’ (originally published in Post Business blog)
by Nashville Health Care Council | Mar 22, 2012

Editor’s note: This is the first in a series of posts from the Nashville Health Care Council’s Leadership Health Care Delegation to Washington. Click here for other installments from the trip.

What will be the outcome of the Supreme Court’s review of the Patient Protection and Affordable Care Act? How much will the 2012 election influence the direction of health care policy? What’s next for payers and providers? These were just some of the questions considered during the first day of sessions at the Nashville Health Care Council’s Leadership Health Care 10-Year Anniversary Delegation to Washington, D.C.

One hundred Leadership Health Care delegates from Nashville and other parts of the country heard from a slate of speakers on March 21, including the dean of the Supreme Court Press Corps Lyle Denniston, who outlined the Court’s schedule for reviewing the reform law early next week. Though Denniston declined to make a prediction about the decision, he described several possible scenarios – including one in which the court rules part or all of the law unconstitutional or even decides there is no legal right to challenge the individual mandate clause until its actual enforcement in 2014.

Denniston also stressed the importance of the court’s look at the issue of severability – whether judges can strike down the individual mandate separately from the rest of the Affordable Care Act, or if striking it down requires negating other parts of the law, or the law in its entirety.

“Don’t overlook the argument about severability,” Denniston said. “It’s a very interesting argument.”

Prior to Denniston’s talk, the delegation heard from Sheila Burke, professor at the John F. Kennedy School of Government and Georgetown University and senior public policy advisor to Baker Donelson Bearman Caldwell & Berkowitz. Burke provided an overview of the political landscape in Washington with regard to health care in which she stressed that nothing is certain – from the fate of the Affordable Care Act to the 2012 election season to future changes or reductions to Medicare and Medicaid.

Longtime health policy analyst Burke noted, “What we know is that everything is in play.”

With regard to the upcoming election, she said one can imagine a scenario of status quo or radical change, but no matter what, partisanship is a given.

“One thing we can assume is a continued deep partisan divide,” she said. “With less and less incentive to compromise, there will be more polarization.”

Political predictions also were part of the panel discussion that wrapped up the day’s sessions. Chip Kahn, president and CEO of the Federation of American Hospitals, called the coming election seminal.

“If the president is re-elected, I’ll predict health reform in some form like it was legislated will happen,” he said. If not, he expects the coverage aspects of the law will be repealed eventually, if not immediately in 2013.

Joining Kahn on the panel, which moderated by Ernst & Young’s Anne Phelps, were Jonathan Bush, co-founder and CEO of athenahealth; Rich Deem, senior vice president for advocacy with the American Medical Association; and Karen Ignagni, president and CEO of America’s Health Insurance Plans.

The panel touched on topics ranging from the future of Medicare to end-of-life care to the physician payment formula.

“The breadth and depth of expertise involved in this year’s delegation is phenomenal,” said Judith Byrd, director of Leadership Health Care. “This event truly showcases the intersection of policy and health care at a time when challenges are increasingly complex and the environment is uncertain.”

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