Health Care May Not Want Itself Repealed
SCOTT SIMON, host:
This is WEEKEND EDITION from NPR News. I'm Scott Simon.
Begin this hour looking at the state of health care overhaul. Department of Health and Human Services on Monday is expected to announce rules that will specify exactly how much of each dollar insurance companies must spend on medical care and how much can be used for administrative expenses and profit.
It's the latest in a long string of efforts to try to roll out the new health care law. Many newly elected Republicans heading to Congress list repealing that legislation as a top priority, or at least laying the groundwork for repeal. Here's current Senate Minority Leader Mitch McConnell speaking on Fox News earlier this month.
Senator MITCH MCCONNELL (Republican, Kentucky): Our first goal is to repeal it and replace it and if we have the votes to put it on his desk, we're going to do that.
SIMON: But while many Republican voters may be all in favor of repealing the health law, it turns out there a lot of other traditional Republican backers who are not.
NPR's Julie Rovner has been taking the temperature of the health care industry, and she joins us now.
Julie, thanks so much for being with us.
JULIE ROVNER: My pleasure.
SIMON: So can you say who exactly is not in favor of repeal within the health care industry?
ROVNER: Well, it's most of the big players - hospitals groups, a lot of doctor groups, drug makers, employers, even health insurers. Which is not to say that they all love the law or that they don't want to see changes. But some of them, particularly health insurers, are agitating for bigger changes than others. But almost without exception, they say they'd rather work to make changes to this law than scrap it and start over.
SIMON: Trying to reduce the amount of regulation is a traditional Republican, business-oriented issue. So why are some of these companies and interests, for the moment, siding with the Democratic initiative?
ROVNER: It's really about their own economic survival. You know, basically for everybody in the health care industry if people don't have health insurance they can't afford to buy health care services. So everybody was almost faced with going out of business. Plus, I think it's a little bit late to say that you don't want the government involved in health care when the government is already pretty much paying half of the nation's health care bill.
So in a lot of ways this was really the health care industry negotiating the terms of its surrender. And a lot of the industry got some pretty nice terms, starting with at least 32 million more paying customers who will be able to buy a lot more health care.
SIMON: There are going to be some in the health care industry who are nevertheless dismayed by increased regulations and other reservations and support repeal.
ROVNER: Absolutely. You know, when you're redistributing 17 percent of the nation's economy, there's going to be winners and losers. I think one group that's very upset right now are health insurance brokers - the people who used to help individuals buy insurance. They're worried that when these new exchanges - these marketplaces - come online, they won't have anything to do.
There is still a lot of small business groups that are very much agitating for repeal, despite the fact that there's a lot in this law that's supposed to make insurance less expensive for small business. These groups, I think, are really still strongly ideologically with the Republicans in favor of repeal.
SIMON: Near as you can tell, Julie, will this apparent hesitation to repeal the law on behalf of some major health care interests in any way tamp down the resolve that Republicans in Congress have to move forward with repeal?
ROVNER: Well, you know, it's been a big electoral issue for Republicans. They see it in their voting base being very strong. On the other hand, you know, a lot of these are big donors for Republicans. And a lot of these groups, they're going to come to Congress and say we really want to make changes in the law, we don't necessarily want to see the law repealed.
So it's going to be a push and pull for a lot of Republicans. There could be legislation to make some changes that a lot of Democrats would agree to. No one suggested this law was going to be fixed in stone.
We could end up seeing a split among Republicans - some who would be willing to make some changes and some who really want to push this repeal rock down the road, if you will, in anticipation of 2012. So we're really going to have to just watch and see what happens.
SIMON: NPR's Julie Rovner, thanks so much.
ROVNER: You're very welcome.
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