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Sidelined healthcare lobby stymies Republican healthcare effort

Sidelined healthcare lobby stymies Republican healthcare effort
From Reuters - July 14, 2017

WASHINGTON (Reuters) - Senate Republicans pushing to overhaul Obamacare largely ignored key players in the debate over insuring the poor: the health insurers and hospitals charged with carrying out the law if it gets approved.

Instead, conservative groups such as Heritage Action for America won the ears of Senate Republicans when it came to changing the Medicaid insurance program for the poor and disabled. The snub is fueling health industry opposition to the new plans for Medicaid, and threatens to further frustrate the months-long effort to dismantle Obamacare.

The latest version of the Senate bill, released on Thursday, left the Medicaid overhaul largely unchanged from the radical makeover in the bill from the U.S. House of Representatives. A nonpartisan government agency has estimated an earlier version of the bill would trim nearly $800 billion in federal spending for Medicaid over 10 years.

While insurers successfully influenced the legislation when it comes to individual insurance markets, the fact that they and hospital groups largely struck out on Medicaid is important because the new provisions shift more costs back to the states and hospitals.

These groups, along with insurers, will be charged with enforcing the new law, so Republicans need their buy-in, health policy experts say.

"A health policy means nothing if it ca not be implemented and does not work," said Andy Slavitt, former administrator under President Barack Obama of the Centers for Medicare and Medicaid Services, which oversaw Obamacare.

Conservative Sway

The Republican bill ends Obamacare's Medicaid expansion and slashes traditional Medicaid funding, with cuts that deepen beginning in 2025. The U.S. House of Representatives passed its own version of the legislation in May.

"A lot of conservatives, Heritage Action included, desperately wanted to hold the line to make sure the Medicaid portion was not watered down in the Senate," said Dan Holler, vice president of Heritage Action for America, a conservative advocacy group. "It was something we made known to folks up in the Senate."

When Democrats and the White House enacted Obamacare seven years ago, support from healthcare companies helped propel the legislation through Congress. The administration actively courted the health industry, lobbyists and former Obama administration officials said, viewing their support as critical to winning votes.

Individual Insurance Changes

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