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LHC in DC: Supreme Court case front and center on first day of delegation

LHC in DC: Supreme Court case front and center on first day of delegation
by Nashville Post | Mar 10, 2015

Editor’s note: This is the first post from the Nashville Health Care Council’s 2015 Leadership Health Care Delegation to Washington. Look for more content from the trip in coming days and click here for entries from past visits.
Less than a week after the Supreme Court heard oral arguments in the controversial King v. Burwell case, 100 of Nashville’s emerging health care leaders visited Washington, D.C., to gather insight into the policy and politics that will shape the health care industry in the year ahead. A slate of expert speakers told attendees of the 13th Annual Leadership Health Care Delegation that Washington is holding its breath as it awaits the court’s ruling, which could eliminate health insurance subsidies for about eight million Americans.

“Everyone is waiting on Secretary Burwell, and I don’t think anybody (in Washington) has a really clear idea of how they’re going to move forward, what the next play is, until they get a ruling on that case,” said CNN Investigative Correspondent Chris Frates (pictured at left), who kicked off the delegation’s two days of sessions with a briefing on the state of affairs in Washington.

Former U.S. Senate Majority Leader Tom Daschle said there’s a general consensus in Congress that something must be done to assist the millions of Americans who would lose their insurance subsidies if the court decides in favor of the petitioners in the case.

Daschle asserted that, while there are areas for bipartisan support on issues like precision medicine, telehealth and the Sustainability Growth Rate (SGR) reform, Congress remains divided on issues related to the ACA.

Anne Filipic, president of Enroll America, echoed other comments about the significance of King v. Burwell, saying there’s “absolutely no way” the eight million people who may lose benefits will be guaranteed the same level of coverage if the court decision comes down against subsidies. As part of a panel discussion on what’s next for the implementation of the Affordable Care Act, Filipic (pictured at right) and her co-panelists said a Supreme Court ruling against subsidies would be devastating for many Americans – particularly since the primary reason most Americans who remain uninsured have not purchased coverage is they assume they can’t afford it.

Of course, as the nation learned with the 2012 Supreme Court decision striking down the ACA provision requiring state Medicaid expansions, most people trying to predict the outcome of King v. Burwell are not constitutional scholars, said panelist Cheryl Jaegar, principal with Williams & Jensen and longtime former staff member for Republican leaders in the House of Representatives. It’s difficult to predict what will happen or how the industry will have to react.

Looking ahead, the panel discussed the possibility of Medicaid expansion in additional states. Mary Grealy, president of the Healthcare Leadership Council, said she could see more states expanding if their Republican governors can find a “Republican way to do it” and the federal government is willing to work with them on waivers.

The first day’s sessions also included discussion of the future of value-based purchasing initiatives, how to continue supporting providers as they work toward achieving meaningful use of electronic health records, the nature of political discussions around fixing the SGR, and of course, the 2016 general election.

Frates, who provided delegates a primer on recent happenings (or lack thereof) in Congress, said he doesn’t see a clear challenger for Hillary Clinton for the Democratic nomination. For Republicans, he thinks timing is an important factor for whoever emerges from the field, given how party favorites like Chris Christie and Marco Rubio have ascended and fallen.

Of course, it could just be a throwback year: “If you have 1992 yard signs, you might want to dust them off: Clinton v. Bush,” Frates said.

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