It's a strategy that the groups fighting the insurance premium tax are also taking.
During an investor event last week, Heidi Margulis, Humana's senior vice president of public affairs, cited bills in the House and Senate that would repeal the tax, as well as new opportunities in the lame-duck session and during budget deficit discussions.
“The premium tax would be on the table,” Margulis said. “There are a number of things that could be considered, both legislatively and through executive discretion with regard to the tax. In a grand bargain, everything's on the table.”
Employer groups are also continuing to push for changes to the premium tax, according to a spokesman for Stop the HIT, a coalition of employer groups that was formed in May 2011 to repeal the premium tax and is planning a campaign. The National Federation of Independent Business, which led one of the legal attacks that landed the reform law before the U.S. Supreme Court, is a leading funder.
Neither tax is likely to be repealed, said Paul Van de Water, senior fellow with the Center on Budget and Policy Priorities, a liberal research and policy institute. “If you get rid of either or both of these taxes, you need to make up for it somewhere else,” he said.
The Obama administration has not indicated it would support a repeal of either provision, which would create a funding shortfall for the law.
The healthcare law's cuts in Medicaid disproportionate-share hospital payments remains a major focus of hospital advocates, although a major legislative push may not come until next year.
Hospitals—especially safety net facilities—have long opposed the cuts but accepted them with the understanding that the healthcare law would reduce the number and costs of uninsured patents they treat by requiring states to cover millions of more Americans under Medicaid. The number of states that will do so became unclear after the Supreme Court concluded HHS can't penalize them for declining the expansion.
Hospital leaders said they plan to launch a legislative push to reverse DSH cuts next year if states go through with their threats not to expand their Medicaid enrollments. In the meantime, hospital lobbying efforts on Medicaid will target state governments.