Government and Health Care

Obamacare takes turn toward compromise

November 8, 2012
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Obamacare takes turn toward compromise
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Some in health care are viewing President Obama's victory as a validation of the Patient Protection and Affordable Care Act (PPACA).

The election also produced a Congress that will assure divided control between the two parties of our nation’s legislative branch, with Democrats maintaining their Senate majority and Republicans controlling the House of Representatives.

What this probably means is that there will be attempts to amend the PPACA, but repeal is unlikely. Additionally, there will be attempts to withhold some funding for the PPACA implementation –– although there is little likelihood of significant change, because most of the law's major provisions already received the necessary funding approval as part of its original enactment.

However, PPACA will again have political importance in the 2014 mid-term elections if there are major implementation problems. Therefore, some compromises are likely. For example, the concern of Autocam’s John Kennedy that the PPACA forces coverage of birth control, in spite of an employer’s religious beliefs, must be addressed, unless more cynical forces want such matters to fester rather than be resolved. It will be important for supporters and detractors to learn how to jointly address key deficiencies in a constructive manner.

Health care providers now must take on strategies that can position them for success.

The President is term limited, but he has to govern for at least two years before lame-duck status will be a significant issue. Neither his party nor the nation can afford political brinksmanship that leads even to a modest recession.

Health care providers must be prepared to face cuts in reimbursement, as the PPACA did not control costs, and the nation cannot afford more debt. The “fiscal cliff” poses major problems for Medicare and Medicaid. Any special interest groups that rely on these programs will either be forced to attack each other arguing for a figurative deck chair on the Titanic or support compromises. The President and the Congress have to deal with the Bush era tax cuts, sequestration and the deficit. If these issues are handled by significant compromise, providers could see major cuts.

Medicare and Medicaid represent about one-fourth of the federal budget. Our leaders cannot meaningfully deal with the deficit without including these programs.

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