Muted Response From Health Lobby as Affordable Care Act Faces Repeal

WASHINGTON — The speed of Republican efforts to repeal the Affordable Care Act has stunned health industry lobbyists, leaving representatives of insurance companies, hospitals, doctors and pharmaceutical makers in disarray and struggling for a response to a legislative quick strike that would upend much of the American health care system.

The Senate is expected to take the first step by Thursday morning, approving parliamentary language in a budget resolution that would fast-track a repeal bill that could not be filibustered in the Senate. House and Senate committees would have until Jan. 27 to report out repeal legislation. Health insurance and health care for millions of Americans are at risk.

But far from reflecting the magnitude of the moment, the most prominent message from lobbyists that lawmakers saw in their first week back at work was a narrowly focused advertisement from the U.S. Chamber of Commerce demanding the repeal of “Obamacare taxes,” especially an annual fee imposed on health insurance companies to help pay for the expansion of coverage under the health law.

“More than 20 million people could lose their health insurance, and states could lose billions of dollars in Medicaid money,” said Kenneth E. Raske, the president of the Greater New York Hospital Association. But, he added, many health care executives “don’t want to get on the wrong side of the new administration or the Republican majority in Congress.”

Health care professionals are not totally silent, but industries that were integral to the creation of the Affordable Care Act in 2010 are keeping their voices down as Republicans rush to dismantle it. Some Republican lawmakers are openly fretting about their leaders’ repeal strategy, saying they must develop an Affordable Care Act replacement before they repeal it. Five Republican senators proposed on Monday to extend the deadline for drafting repeal legislation by five weeks, until March 3. One of the five, Senator Bob Corker of Tennessee, said the extra time would allow Congress and the Trump administration to “get the policy right” as they try to arrange a smooth transition to a new system of health coverage.

But the naysayers are getting no cover from a major lobbying and advertisement blitz like the ones that blanketed the airwaves in 2009 and 2010.

To block the repeal effort, said Senator Richard J. Durbin of Illinois, the No. 2 Senate Democrat, “we need two or three Republicans to join us.”

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Jeffrey R. Ungvary President

Jeffrey R. Ungvary