Congressional Representatives Provide Differing Views on Health Care Reform

If the Supreme Court rules that the Patient Protection and Affordable Care Act is unconstitutional, Congress will work on retaining certain provisions in the law that enjoy bipartisan support. That was one of the main messages delivered by Rep. Cathy McMorris Rodgers, R-Wash., in the keynote address at this year's Family Medicine Congressional Conference here May 14-15.

McMorris Rodgers told the nearly 200 family physicians at the conference that Congress is trying to anticipate how the Supreme Court might rule on the Affordable Care Act. "Should the Supreme Court rule that any part of the health care (law) is unconstitutional, we (Congress) are prepared to move forward immediately to try and prevent some of the chaos in the marketplace," said McMorris Rodgers.

She identified three provisions in the law that Congress would work to retain if the Supreme Court strikes down the Affordable Care Act:

The Supreme Court is expected to rule on the constitutionality of the health care reform law next month.

State-based health insurance exchanges created by the Affordable Care Act also might bring Democrats and Republicans together, said McMorris Rodgers. However, she added, Republicans are nervous about the role of the federal government in "mandating what every plan needs to look like within every exchange."

"What I would like to see within the (exchanges) are as many options as possible. For those who want to have a health savings account, they should be able to do so. If they want a different type of plan, they should be able to do that, too."

McMorris Rodgers is an outspoken critic of the Affordable Care Act, saying during her opening remarks that over the years, the "federal government has added countless regulations, costs, unfunded mandates, liabilities and hoops for the patient and doctor to jump through."

"The 2010 health care (law) multiplies these entanglements and proposes a level of conflicting micromanagement that will further erode the basic task of taking care of patients."

On the other end of the spectrum was Rep. Frank Pallone, D-N.J., the ranking Democrat on the Energy and Commerce's Subcommittee on Health, who addressed conference attendees May 14 during a reception sponsored by FamMedPAC and the AAFP grassroots advocacy program.

Pallone's message was that the health care reform law will greatly expand access to care, benefiting both patients and physicians alike. He also stressed that the Affordable Care Act is focused on prevention and wellness, making primary care a key component of the health care reform law.

"You all know that prevention pays off," said Pallone. "We don't want people going to the emergency room. We want them to have insurance."

Pallone also addressed the sustainable growth rate (SGR) formula, calling for a long-term fix. "Everyone is tired of six-month extensions, nine-month extensions or even, in some cases, one-month extensions," said Pallone.

Congressional Democrats have urged Congress to use savings from reductions in military operations in Iraq and Afghanistan to cover the cost of repealing the SGR. "You should talk about how we have to have a long-term fix," Pallone told AAFP members, who planned to visit their congressional representatives the following day.

But Congress should not take money from the health care system itself to pay for the SGR repeal, Pallone said. That amounts to "robbing Peter to pay Paul."