The lead author of the 2010 healthcare overhaul confirmed Tuesday that he will not seek re-election when his term expires next year.
In his role as chairman of the Finance Committee, Sen. Max Baucus (D-Mont.) shepherded the legislation that became the Patient Protection and Affordable Care Act over united Republican opposition. Since then, he has conducted oversight of the implementation of the complex law. Last week, Baucus told HHS Secretary Kathleen Sebelius he feared the administration is headed for a “huge train wreck”
with the launch of the health insurance exchanges this year given the lack of information available to the public and policymakers.
According to a written statement issued by his office, “implementing and expanding affordable healthcare for more Americans” is among Baucus' priorities for the remainder of his final term. “I'm re-energized,” Baucus said when asked whether oversight of the Affordable Care Act might falter now that it's known he will be gone soon. “I have more energy and time; I don't have to worry about campaigning,” Baucus said. “I'd rather focus on substance and the ACA is a large part of that, as well as tax reform.”
Baucus cited his desire to focus on policy during the remainder of his current term—instead of campaigning—as the reason for his retirement.
His fellow senators in both parties were caught off guard because Baucus was busily campaigning for re-election and had amassed a huge campaign fund. Both Republicans and Democratic members of the panel said they doubted Baucus' departure would have much short-term impact on health policy or oversight.
Sen. Orrin Hatch, senior Republican on the Finance Committee, told reporters he was surprised by the news and was unsure what impact it would have on health policy. He called Baucus' authorship of much of the healthcare law a “signal achievement.”
“He rammed it through committee; it was a very difficult thing to do,” Hatch said. “But he did what they asked him to do—and when I say 'they,' I mean Democrats.”
Sen. Richard Blumenthal (D-Conn.) said in an interview: “He's going to be around, so I don't think it's going to directly impact either healthcare or any other measure for the next couple years.”
Rick Pollack, executive vice president at the American Hospital Association, praised the Montana Democrat for his contributions to U.S. healthcare policy.
“Senator Baucus has left his imprint on virtually every piece of healthcare legislation over the past few decades,” Pollack said in an e-mailed statement. "He has provided important leadership in expanding healthcare coverage for millions of Americans, and he has been a tireless advocate to ensure access to care in rural and frontier communities," he continued. "His door has always been open to the hospital community because of his sincere interest in understanding our challenges and concerns. He will be missed."
Meanwhile, the Medical Group Management Association noted that Baucus' influence in the Senate will continue to play a pivotal roll as policymakers and healthcare interest groups seek a permanent solution to Medicare's troubled physician payment system.
"The next year and half will be challenging, especially as it relates to health exchange implementation and fixing the Medicare physician payment system," Anders Gilberg, senior vice president at the MGMA, said in an e-mail. "Sen. Baucus' leadership in the Senate through the end of his term will be critical to overseeing reform implementation and repealing the SGR once and for all."
The news came as a surprise to Dr. Nicholas Wolter, CEO of the Billings (Mont.) Clinic, who has known Baucus for about 25 years. In a phone interview with Modern Healthcare, Wolter said it was Baucus who nominated him to serve on the Medicare Payment Advisory Commission, where Wolter served two three-year terms, from 2002 through 2005 and 2005 through 2008.
Wolter, who spent 15 years as clinician at Billings before he became CEO 15 years ago, said he doesn't know all of the factors Baucus weighed before making his decision. When asked if opposition to the Affordable Care Act in Montana could have been a leading factor, Wolter said that while there are Montanans who want to repeal the 2010 law, there are others who appreciate the work that went into it and think it's the right direction for the country. He also said Baucus has made a significant contribution while serving in the upper chamber, especially in the Senate Finance Committee.
"Personally I think he has quite a track record in healthcare policy, particularly as he stepped in the Senate Finance Committee leadersnip roles, both as ranking and ultimately as chairman," Wolter said, adding that Baucus had a number of talented people working with him on the committee over the years, including Liz Fowler, who worked on the healthcare reform law as a counsel to Baucus and later worked at the White House before leaving for Johnson and Johnson; and Jonathan Blum, who currently serves as deputy administrator and director for the Center for Medicare at the CMS. "I think it's going to be a big loss," Wolter said. "Not just for Montanta, but for the country."
Early speculation for Baucus' replacement atop the powerful Finance Committee included Sen. Ron Wyden (D-Ore.), although he declined to address the possibility when asked by reporters.
“My bottom line is that the country is expecting the Finance Committee over the next two years to focus on the country's priorities and that includes improving the fiscal picture, fixing this broken dysfunctional mess of a tax code and dealing with what is a demographic tsunami with implications for Medicare,” Wyden told reporters. “What I'm going to be focused on over the next two years is those issues.”
The possibility of Wyden taking over the committee's chairmanship drew positive responses from at least one of his colleagues.
“There is a possibility” for health policy change if Wyden took over, Sen. Charles Grassley (R-Iowa), a senior member of Finance, said in an interview. “Wyden has shown a lot of independence on healthcare and Medicare.”
Wyden co-sponsored a Medicare overhaul plan in 2011 with Rep. Paul Ryan (R-Wis.) that aimed to slow the growth of the program's costs, in part by incorporating Ryan's controversial proposal to gives seniors vouchers to get coverage from private health insurance carriers. That drew praise from some conservatives and criticism from liberal groups
— with Jessica Zigmond
Follow Rich Daly on Twitter: @MHrdaly
Follow Jessica Zigmond on Twitter: @MHjzigmond