For several weeks, doctors, hospitals, and health insurance companies would have losing health insurance to Republican lawmakers, and they issued terrible warnings when the hospital helped Donald Trump’s expenses for big taxes and expenditures.
However, the Republican Party ignored the pastoral and cut a deeper cut and sent the bill to the White House on July 3. There Trump signed the next day.
The passage of this law showed rare political losses for the largest players in the health industry. When unified, doctors, hospitals and insurance companies have been in the most powerful lobby forces in Washington and have long results in blocking or coercion of laws that can harm financially.
However, health industries lobbyists have been breathable and evaluated by the Republican votes within two months of Congress, after the large -scale legislation of Trump competed.
Some lobbyists have suggested a lot of reasons for not preventing significant cuts to Medicaid, a $ 900 billion state health insurance program. 72 million low -income and disabled people nationwide And it occupies 19% All spending on hospitals According to the latest data, about $ 28.3 billion nursing every year. But almost all agreed that GOP lawmakers were more concerned about getting angry with Trump than to face the backlash of local hospitals and people returning home.
Bob Kocher, a partner of Venrock, a venture capital company, served by the Obama administration, said, “Members were afraid of issuing a primary challenge than Trump’s closed or premiums.
SEN. Consider what happened to Thom Tillis (RN.C.). Trump threatened to take the Senate to promote the opposition to the bill due to the reduction of Medicaid, and threaten to support Tilisu’s challenger next year. Shortly after that, Tillis announced his retirement in politics.
But other factors were working.
The health industry warnings of the lawmakers may have been rejected because hospitals, medical centers, and other health care providers are considered a powerful supporter of law, which are law -known laws known as the Democratic Party’s largest domestic achievements for decades by the Republican Party.
The ACA has previously expanded the scope of government health insurance for millions of people who are not qualified. And the Republican did not vote.
Kocher said, “The hospital’s support for ACA frustrated the Republican Party, and as a result, there are fewer goodwill storage for hospitals than in the past.
CECI CONNOLLY, the chief executive of the community health plan allies, said the lobby team spent additional time with the National Assembly and employees, and raised concerns about how the law would guarantee the scope of health care.
“The Republic of Parliament had almost priority to win Trump,” she said. Her group shows a health plan that provides insurance coverage in about 40 states. “The problem has replaced some of their concerns, reluctance and hesitation.”
Connoli has repeatedly focuses on focusing on Trump’s promise of campaigns to extend tax reductions in 2017 from members of the GOP National Assembly.
She said that some moderate members’ concerns helped to lead to one concession.
She said that some lawmakers can easily support legislation to reduce more than $ 1 trillion in Medicade for 10 years.
Another twist: Many new parliamentarians are still learning about Medicade, she said.
The Republican Party also seemed to be eager to reduce the range of Medicaid and Affordable Care Act Marketplace after registering in two programs during the epidemic and Viden administrative period. Trump’s law requires the state to confirm the qualifications of Medicaid every six months and terminate the automatic registration with a market plan.
Charles “Chip” Kahn, a long -time health lobbyist and CEO of the US Hospital Federation, said that the industry’s message was heard in the parliamentary parliament. However, the bill dealt with many other problems, including tax reduction, border security and energy, so the lawmakers had to decide whether to lose potential health security.
Republicans tried to abolish Obama Care, but it was very different from 2017. Khan said Trump’s 2025 action is not a health reform bill or a health bill.
“I got unfortunate consequences.”
But there was some success, Kahn said.
The industry lobby has prevented federal governments from reducing spending on states that have expanded Medicaid according to ACA. Advocates of the hospital and other Medicaids also persuaded Congress not to restrict the open federal funds of this program to the state. Both actions would have won billions of dollars more than additional Medicaid.
The new law does not change or benefit the qualification rules for Medicaid. But it defines it The Lord requires most Medicaid registrants. The expansion of the ACA to work for 80 hours a month or to volunteer, and the guaranteeed by the Council’s budget office predicted that about 5 million people would lose their guarantee by 2034.
This law also restricts the use of the health provider tax system decades ago to take advantage of additional federal Medicide funding. This is another loss of the hospital industry, which supported this practice because it brought higher payments from Medicaid.
Medicaid generally lower the cost of treatment than personal insurance and medicare, a program for people aged 65 or older and people with disabilities. However, due to the provider tax, some hospitals pay more depending on Medicaid than Medicare. According to the Federal FundHealth Research Nonprofit Organization.
KAHN admits that conservative think tanks, Paragon Health Institute and CEO Brian Blase, have made the claim that the provider tax is a legal “money laundering.” BLASE advised Trump for health policy at the first term.
A hospital executive who requested to withhold his name to avoid professional retaliation said that some facilities resonated with GOP lawmakers to use this play to increase their profits. “They thought some hospitals were doing well financially and didn’t want to compensate them,” he said.
Nevertheless, Khan, who retired at the end of the year, was pleased that the Senate delayed the implementation of the provider’s tax reduction by 2028.
TODD EPPLER, the CEO of Desoto Regional Medical Center in the northeastern rural Louisiana, hoped to pass the initial house version of the Congress Guy, which did not include supplier tax funding. But he said he had influenced his hospital in Mansfield, located in the House of Representatives Mike Johnson.
EPPler said, “We are happy to be the end.” I think they have heard of a rural hospital. “
The hospital has argued that for decades, federal funds for Medicaid or Medicare will harm patients and lead to service reduction. Hospitals are generally one of the largest employers in the parliamentary district, so industry leaders often warn about potential job losses. Such arguments usually stop for a while.
But this time the message had little traction.
A health industry lobbyist who asked me not to be honest with professional influence and said that there is a sense of the parliamentary heel that the hospital can withstand financing cuts.
However, there is also a belief that trade groups, including the largest hospital industrial lobby organization, are more effective, including the American Hospital Association. “I have a lot of worries that AHA statements are too soft, too little, and too late,” he said.
The AHA helped lead the union of a hospital organization that spent millions of dollars in television advertisements for the GOP bill. Rick Pollack, president and CEO of the CEO, reduced the Medicaid before the House of Representatives voted on the bill.Destructive blow In the health and welfare of the most vulnerable citizens and communities of our country. ”
POLLACK said in a statement on KFF Health News that Republicans passed the law due to appeals of tax reduction.
“Hospitals and health systems have advocated tired to protect insurance coverage and access to millions of people.” “We will continue to raise these important issues to alleviate the influence of these proposals.”
The American Medical Association also also opposed the reduction of funds for Medicaid and other federal health programs. Bobby Mukkamala said in a July 1 statement that “in the era of struggling to open a rural hospital and doctors, we will shift to the United States, especially doctors and hospitals.”
But AMA also focused on securing higher medical expenses for doctors. This law ultimately included a one -time 2.5% Medicare Pay bump to doctors in 2026. This was not a victory because it excluded the permanent payment correction of the house version that could tie the doctor’s payment to the medical inflation rate. Mukkamala mentioned a temporary lift, but explained that “it is much less than necessary to take care of the elderly in the United States.”
Joe Dunn, the chief policy officer of the National Community Health Center, is constantly to prevent deeper Medicide cuts that can finance the non -profit clinic this year. He said he tried. The Health Center manager visited Washington in February and made thousands of calls and sent email to parliament.
One compensation is that the health center was exempted from the requirement of the law that the provider charged up to $ 35 for the service.
But at the end of the day, Dunn said many GOP houses and senators simply wanted to end the bill. “They went in the direction of satisfying the president’s timeline and goals,” he said.
Washington Correspondent Julie Rovner has contributed to this report.
