Top healthcare executives who gathered in San Francisco this past week at the J.P. Morgan Healthcare Conference widely agreed that the healthcare reform law's coverage expansion and other provisions are not in jeopardy at the hands of congressional Republicans or the Supreme Court.
Really? What wacky weed were those smart, high-paid people smoking out there in the former hippie haven by the Bay?
Repeal of the Patient Protection and Affordable Care Act "is not a possibility," George Scangos, CEO of biotechnology company Biogen Idec told Reuters. "They would somehow have to explain to millions of people that they will lose health insurance."
And if Chief Justice John Roberts and his colleagues strike down the subsidies come June, what then? Never fear, congressional Republicans will save the law, according to business leaders for whom the phrase “whistling past the graveyard” must have been invented.
"Blowing up the (ACA) is like shutting down the government," Aetna CEO Mark Bertolini said, according to Reuters. "So we are having conversations on both sides of the aisle about what ... things you change in the ACA, what we could introduce, about how to make a grand bargain should the Supreme Court decide."
At least Anthem CEO Joseph Swedish was willing to acknowledge the need to consider Plan B if the ACA is torpedoed by the Supreme Court. His insurance company likely will go through “some scenario planning between now and the ruling,” he said in San Francisco. But not quite yet. “Speculation on where the Supreme Court is going to land” is foolish, he said.
There were other doomsday deniers as well. Wednesday, insurance industry consultant Robert Laszewski published a column in USA Today arguing that Republicans should be able to reach a deal with President Obama and the Democrats on “customer-friendly Obamacare fixes” preserving premium subsidies, insurance exchanges, minimum standardized benefits, and Medicaid expansion.
“Republicans need to admit we don't need to 'repeal and replace' Obamacare with another complex ideological health insurance reform plan to make our system work a lot better,” he wrote.
Let's recall what former Indiana Democratic Sen. Evan Bayh recently told Modern Healthcare about the likelihood of Republicans saving Obamacare subsidies if the Supreme Court strikes them down. Bayh is a two-term governor and two-term senator and the son of a former senator who knows a little something about politics. He expressed severe doubts that there are any concessions Obama and congressional Democrats could offer Republicans that would persuade them to salvage the law.
“I can't imagine what would get Mitch McConnell and John Boehner to go back to their caucuses and say, 'Obamacare is on its deathbed and the Democrats are offering the following things that lead us to say let's revive it,' ” says Bayh, now a strategic adviser at McGuireWoods law firm. “They wouldn't do that for the 40-hour workweek or the device tax. You could throw in the Keystone pipeline and the kitchen sink and they still wouldn't revive it. Any Republicans who agree to reinstate the subsidies and therefore rescue the mortally wounded law would be eviscerated by their right wing and would face primary challenges. I can't think of any political calculus that gets them there.”
If Bayh is right—and he's not alone among smart political observers—there is a lot of deeply wishful thinking going on among healthcare industry leaders.
Follow Harris Meyer on Twitter: @MHHmeyer