Affordable Care Act Special Interest Group

Special Interest Groups and the Affordable Care Act This paper analyzes the stand taken by the following Special Interest Groups on the Affordable Care Act. American Medical Association (AMA) American Association of Retired People (AARP) American Hospital Association (AHA) U.S. Chamber of Commerce National Federation of Independent Business (NFIB) National Retail Federation (NRF) American Medical Association (AMA) The American Medical Association (AMA) is a professional association of physicians in the United States and has around 243,000 members according to AMA’s 2017 annual report.

The AMA supports the Affordable Care Act.

The association advocates universal health care for all Americans as well as pluralism, freedom of choice and practice and universal access for patients (AMA. 2018). The AMA is against the current government’s efforts to repeal or replace the Affordable Care Act as outlined in the Better Care Reconciliation Act (BCRA), the Obamacare Repeal Reconciliation Act (ORRA) or the American Health Care Act (AHCA).

It strongly advocates continuation of health insurance coverage for those who are currently covered, maintain insurance market reform like pre-existing conditions, strengthening of the individual insurance market, provision of affordable health insurance for low income patients and also adequate funding for safety net programs like Medicaid, reduce regulatory burdens, greater cost transparency and new physician-led payment models.

(AMA, 2018). Based on the association’s 2017 annual report, the AMA had a 13.8 million operating income with a total revenue of 347 million dollars.

The Center for Responsive Politics (CRP), using data released by the Federal Election Commission, Senate Office of Public Records, estimates that the AMA spent .

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7 million in 2017-2018 for lobbying. The bill most frequently that AMA lobbied against was the American Health Care Act. (CRP 2018).

American Association of Retired People (AARP) AARP is an interest group which claims to be America’s largest nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age. The AARP lobbies the congress for the following causes. (AARP, 2018)

1. Proposed budget cuts and other changes don’t jeopardize access to health care in rural areas.
2. Protect Medicare by rejecting the proposed repeal of a 0.9 percent increase in the payroll tax for higher-income workers.
3. Oppose a per-capita cap on Medicaid funding, which would put at risk the care of some of our most vulnerable citizens, especially the 17 million poor seniors and disabled adults and children who rely on the program.
4. Back the proposed Credit for Caring Act, which would provide a tax credit of up to $3,000 to eligible working family caregivers.
5. Restore the medical-expense deduction, which provided relief for the oldest and sickest Americans who face high health care costs.
6. Restrain drug price hikes, such as by allowing Medicare to negotiate with pharmaceutical companies for lower prices.

Based on its annual report for 2017, AARP’s consolidated operating revenues in 2017 were $1.64 billion and its operational expenses were $1.65 billion with total assets of nearly $4.3 billion and net assets of $1.7 billion. The Center for Responsive Politics (CRP) estimates that AARP spent $13.9 million in 2017-2018 for lobbying. The bill most frequently that AARP lobbied against was the American Health Care Act. (CRP 2018).

American Hospital Association (AHA) American Hospital Association (AHA) is a professional association which represents all types of hospitals, health care networks, and their patients and communities. Nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members are part of the AHA. The stated vision of AHA is a society of healthy communities where all individuals reach their highest potential for health. The AHA supports the Affordable Care Act and opposes its repeal or replacement. (AHA, 2018). The AHA’s 2018 advocacy agenda includes the following items among other things.

1. Preserve the gains in health coverage made in this decade by advancing alternatives to the
2. federal individual coverage mandate.
3. Ensure the stability of the Health Insurance Marketplaces by fully funding the cost-sharing reduction subsidies, implementing a reinsurance program, ensuring accurate risk adjustment, ensuring sufficient federal outreach and enrollment efforts, and protecting against non-Affordable Care Act compliant health plans.
4. Provide states with tools to extend coverage and care to their population through the use of innovative state waivers (section 1115 and 1332 waivers) with appropriate safeguards.
5. Protect against reductions in Medicaid coverage by advancing solutions to improve the sustainability of the program.

Ensure that our veterans are cared for by working with hospitals and health systems as they contemplate the next generation of a comprehensive community care plan for veterans. Based on taxes filed for year 2015, AHA’s total revenue was $127.7 million and expenses were $116.5 million with a net income of $11.2 million. The net assets were $176.7 million.

The Center for Responsive Politics (CRP) estimates that AARP spent $33.3 million in 2017-2018 for lobbying. The bill most frequently that AARP lobbied against was the American Health Care Act. (CRP 2018). U.S. Chamber of Commerce The U.S. Chamber of Commerce is the world’s largest business organization representing the interests of more than 3 million businesses. It is the largest lobbying group in the US (The Hill, 2017).

It supports the American Health Care Act that seeks to repeal and replace the Affordable Care Act. It seeks to provide relief to employers and employees as the ACA is implemented by reducing the harm of the employer mandate by restoring the 40-hour work week, repealing taxes that increase premiums and cost jobs such as the 40% excise tax, medical device tax, and the health insurance tax; and improving flexibility for tax-preferred accounts that encourage careful health care spending like FSAs, HSAs, and HRAs. The “2017 Health Care Policy Recommendations” brief issued by the group outlines its stand on various provisions of the ACA.

The report has 2 sections, the first section outlines the various mistakes of the Affordable care act and suggests ways to rectify them. The second section details positive proposals that go beyond rectifying the mistakes of the ACA.

According to the Center for Responsive Politics (CRP) the US Chamber of Commerce spent 69.1 million in 2018 for lobbying. (CRP 2018) National Federation of Independent Business (NFIB) The National Federation of Independent Business (NFIB) is the largest small business association in the U.S. The NFIB is against the ACA and advocates its repeal. It was the chief litigant against the ACA and lost its case in the Supreme Court in 2012.

They believe that health insurance markets should be repaired to make them affordable, flexible and predictable. (NFIB 2018) According to the Center for Responsive Politics (CRP) the NFIB spent 2.1 million in 2018 for lobbying. The bill most frequently lobbied on by the NFIB is the bill to repeal the annual fee on health insurance providers as enacted by the ACA (CRP 2018). National Retail Federation (NRF) The NRF is the world’s largest retail trade association. Its stated mission is to advance the interests of the retail industry through advocacy, communications and education. (NRF, 2018).

NRF advocates the full repeal of the ACA employer mandate that requires large companies to provide health coverage to full-time workers at government-dictated levels, restoration of the 40-hour workweek for benefit eligibility, repeal of ACA taxes including the Cadillac Tax and Health Insurance Tax, and changes to the ACA reporting rules. According to the Center for Responsive Politics (CRP) the NFIB spent 2.1 million in 2018 for lobbying (CRP 2018)