PPACA repeal effort reenergizes reform conversation

A vote in the House of Representatives on the “Repealing the Job-Killing Health Care Law Act” (HR 2) scheduled for Jan. 12 has been postponed in the wake of last weekend’s shootings in Arizona, and although a new date has yet to be scheduled, Capitol Hill watchers expect the legislation to resurface soon.

EBA asked our health care reform panelists to weigh in: Is the repeal effort — which President Barack Obama has already affirmed will not make it past his veto pen (were to get that far) — an important symbolic gesture, a waste of time, or somewhere in between?

Revisiting the Patient Protection and Affordable Care Act will give Republicans in the House an opportunity "to show the American people that they intend to keep the promises they made during the election," says Gary Herbruck, president of Indiana’s Coordinated Benefit Design.

"Whatever they do, they should refuse to compromise with the Democrats on anything — especially with regard to the job-killing health care legislation," he adds.

On the other side, Kris Marohn, an administrator with McCall, Parkhurst & Horton in Dallas, says, "If this isn’t a publicity stunt, I don’t know what is … this is all grandstanding — a huge political publicity act to get attention."

Dave Lapka, president of logistics consulting company D360, agrees it’s politically motivated, but says the legislative action is nonetheless worthwhile "to make everyone take a stand that can't be altered or denied in the future."

Afterward, Lapka believes House Republicans should move forward to pass "real legislative changes that will reduce the cost of health care, increase motivation and level the playing field for self employed and private citizens to secure health insurance,” he says. "That way, average Americans can compare what's being enacted by whom, and vote based on the clear choice the two plans would offer."

Cyndy Nayer, president of the Center for Health Value Innovation, points out that the cost of repealing PPACA could add billions of dollars to the budget.

"Even if we could afford that, the derailing of the new health information technology that is coming forward would be an awful blow, as would some of the new health care models” such as accountable care organizations, patient-centered medical home, comparative effectiveness and outcomes-based contracts, she says. “It's quite interesting to watch the repositioning on both sides of the aisle. My hope is that we achieve a balance of dollars spent, dollars to be spent, and, most importantly, health that will be improved."

More important than the vote on repealing health care reform will be the hearings that are expected to be held in House committees on PPACA, says Bill Sweetnam, principal, Groom Law Group in Washington, D.C.

"Having a detailed discussion on provisions of the bill (such as the operation of tax credits through the exchanges or how the nondiscrimination rules are to operate) will raise important issues that need to be thought about in any worthwhile discussion of whether this health care reform bill is a good idea," says Sweetnam. 

Pat Carpenter, vice president of business development with Ohio’s Sequent Retirement & Benefits Group, believes congressional action on PPACA will “honor the concerns” of voters.

"Congress needs to keep the goals of making coverage available to more people, but figure out a better way," says Carpenter, who would like to see changes to the tort reform system, a limit to pain and suffering medical malpractice awards, the ability for carriers to bid across state lines and changes to the tax code.

Michael Powers of Corporate Benefit Advisors in Delray Beach, Florida, agrees that new solutions must be found and that the repeal is more than a symbolic gesture.

He believes it will encourage better understanding of the "cost-centric" consequences of PPACA. Powers hopes for "practical solutions such as allowing insurers to sell across state lines, medical tort reform, extended worksite wellness employer tax incentives” and mass education on long-term care insurance."

While he believes the new Congress is sincere in its attempt to repeal health reform, Andrew Butler, president of Butler Benefit Service in Davenport, Iowa, says the passage will be a "hollow victory" without any significant bipartisan support. Butler knows managing health care costs to a rate of change no greater than that of the economy as a whole is possible because he is able to do so with his own clients.

"Our clients have experienced overall cost increases of less than 3% in each of the last 10 years,” he explains. “It is not complicated to achieve those results, either. The change we see is systemic and inherent in the people and has nothing to do with cost shifting or plan design. Those tools only further improve the cost effectiveness of our clients’ plans," he says.

Whether or not anything comes out of the repeal vote, Kathleen Somers, executive assistant with the Management Liability Practice Group at Arthur J. Gallagher & Co. says it’s worth the effort, "because it keeps it alive in the minds of all of the American people and the elections are coming up in 2012, so the Republicans are positioning themselves with the health reform bill by trying to eliminate what is not good, keep what is good and add in what needs to be done that is not currently there."

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