‘A huge impact’
Lobbyists say the GOP Doctors Faction has a lot of influence over the Republican conference, and its members are working on a number of bipartisan health policy issues. Modern Healthcare provided anonymity to some lobbyists who wanted to speak frankly without jeopardizing their relationship on Capitol Hill.
“As for the Republicans, I have always believed that the doctors’ meeting has a huge impact on health policy to the point that they even wrote bills that became laws,” said a lobbyist representing several different parts. industry.
For example, when Republicans controlled the House of Representatives in 2015, Rep. Michael Burgess (Texas), obstetrician-gynecologist and congregation played a key role in abolishing the Sustainable Growth Formula and creating a new way to pay doctors through the Medicare and CHIP Re-Authorization Act.
Senator Bill Cassidy (R-La.) Was among the leaders of the GOP efforts to repeal and replace the ACA in 2017. Although this gambit failed, President Donald Trump borrowed some of the gastroenterologist’s ideas and tried to implement them through regulatory means.
Doctors have also been heavily involved in the unexpected billing ban that Congress passed last year. The end product was seen as convenient for suppliers, and several doctors served on committees that helped draft the law. Doctors in Congress are currently opposing Medicare and Medicaid Services Centers, which are responsible for enforcing the law, for proposing rules they think are too friendly for insurers.
Another lobbyist said that when Republican leaders need to test the waters in health policy, their first stop is a GOP physician meeting. Their strength lies in their numbers, but according to lobbyists, it is also one of the most organized gatherings in the House of Representatives. Many congressional factions are mostly nominally only, but the GOP physician faction actually holds meetings, meets with outsiders, issues political statements, and helps pass bills.
The lobbyist, who has worked in several industries, added that Democrats usually don’t care about their members’ professional experience. The lobbyist said Republicans place much more value on the medical expertise of legislators, making them important ambassadors at their conference when it comes to health policy.
Several Republican doctors serve on committees that write health laws. Burgess chaired the House Energy and Commerce Health Subcommittee for several years, including when the GOP tried to repeal the ACA in 2017. Three of the four Senate Republican doctors – Cassidy, Marshall, and Paul – serve on the Senate Committee on Health, Education, Labor, and Pensions. Republican Senator John Barrasso, Wyoming, an orthopedic surgeon, and Cassidy are members of the Senate Finance Committee.
While Republicans are a minority in both chambers, there is a very real chance they can reclaim a majority in 2022 by bringing the GOP physician faction back to the fore in health policy making.
The last time Republicans had a majority, they tried to repeal the ACA, block the provision of Medicaid and restrict access to abortion. The party successfully canceled the ACA’s individual mandate, prompting legal action by Republican government officials who threatened to destroy the ACA but ultimately failed in the Supreme Court.
When a meeting is successful, it is usually about less controversial issues, such as reimbursement by a doctor.
This is the driving force behind much of the faction’s work, Burgess said. “Most of us in the office now moved here from private practice, where we ran our own practices and made our own hiring and firing decisions,” he said.
This is why Republican physician legislators are the first people lobbyists turn to when they need help with payment and practice. “If you were a provider who was at the forefront of addressing the (administrative) burden, those with that experience would be most helpful,” said the provider’s lobbyist.
First elected in 2012, Rep. Brad Venstrup, Ohio, an orthopedic surgeon, recalls being frustrated by annual worries about looming fee cuts as a result of sustained growth policies.
“Congress has consistently told doctors across America to keep visiting patients, paying staff, and paying bills,” Venstrup said. “There must be some income. We had to go and get a loan. I don’t know that everyone in Washington understands this. ”
There is some bipartisan support on some of these smaller health issues, according to Rep. Amy Bera, Calif., A physician who works with Congressman Larry Bakshon, Indiana, a cardiothoracic surgeon. insist on increasing Medicare wages.
“If you give up their attempts to cancel the ACA, put that aside and address some of the social issues,” Bera said, “we’ll have more places where we can work together.” “Pay reform, prior authorization and staff problems are some examples,” he said.
Another area that Republican and Democratic doctors in Congress are citing is frustration with increasingly onerous insurance rules.
Venstrup and Ruiz are working on legislation to limit “step therapy,” an insurer’s policy that requires patients to try cheaper drugs first and then switch to more expensive ones.
“Doctor. Ruiz and I can very easily understand what this sometimes does with patient care, ”said Venstrup. “You have people who decide that someone should go for treatment, even though they have never even seen a patient before. It doesn’t seem right. “
These bills may not be promoted next year, but the approaching interim dates and the post-election session of the lame duck could mean that Congress will address bipartisan priorities.
Specialty versus primary health care
Almost all Republican doctors serving in Congress are specialists, unlike most American doctors who practice primary health care, family medicine, or pediatrics. But these legislators tend to represent the political views of most of their fellow practitioners: surgeons, anesthesiologists, urologists, and other professionals are more likely to be registered Republicans, according to a 2016 New York Times analysis.