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Clearly, health care reform will remain a contentious issue during the current presidential election cycle and beyond.
The House of Representatives started the new year by voting to gut the Affordable Care Act. Passage of the legislation, by a 240-to-181 margin that closely mirrored the breakdown among parties in the Republican-controlled body, together with a 52-to-47 vote in the Senate last month, put the measure on the desk of President Obama, who promply vetoed it.
The House action was the 62nd time it voted to repeal the ACA, activity that critics have characterized as wasteful, since, as long as Obama is in the White House, he is certain to use the veto to prevent the dismantling of his signature domestic policy initiative.
This is the first time the measure has gotten through the Senate, where majority leader Mitch McConnell (R., Ky.) employed a legislative tactic known as budget reconciliation — the same one that Democrats utilized in 2010 to enact the ACA — to stave off a potential filibuster.
Why all the effort for legislation that doesn’t command enough support to override a veto and has no chance of becoming law?
Speaker of the House Paul Ryan (R., Wis.) addressed the issue at a press briefing following the House vote: “We are confronting the president with the hard, honest truth — Obamacare doesn’t work,” he said. “Higher premiums, fewer choices and restricted access — these are not signs of success.”
While some might be tempted to dismiss the legislative action as motivated solely by election year politics, it is significant that a majority of both houses of Congress think the framework that governs the nation’s health care system, which accounts for almost 20% of the gross domestic product, should be done away with.
The divergence of opinion in Washington on Obamacare reflects sentiment throughout the country. A recent poll conducted by the Kaiser Family Foundation revealed that Americans remain evenly split on the ACA, with 46% holding an unfavorable view and 40% voicing their support.
The challenge for both Republicans, who would do away with the ACA, and Democrats, who understand that a law of such magnitude inevitably requires fine-tuning after it takes effect, is to put concrete proposals on the table.
Obamacare has done a reasonably good job in expanding the number of people who have health care coverage, but much work remains to be done in terms of controlling costs — which at $8,713 per capita are more than double the $3,453 average for members of the Organization for Economic Cooperation and Development — as well as sifting through the issues cited by Ryan.
In the meantime, the Obama administration continues to implement its vision of health care. The Department of Health and Human Services announced earlier this month that thus far more than 11.3 million people have signed up for coverage through the health insurance marketplaces created by the ACA.
“We’re seeing unprecedented demand for marketplace coverage,” said HHS Secretary Sylvia Burwell. “We’re encouraged that marketplace consumers are increasingly young, engaged and shopping for the best plan. We have more work to do before the next deadlines, and our focus continues to be the consumer experience and educating consumers about available financial assistance and their choices.”
The absence of consensus on health care reform almost six years after the ACA was signed into law complicates things for pharmacy operators and other health care providers. As much as business executives and investors crave certainty, they will have do without it, at least for the near term, when it comes to health care policy.
It is fortunate — both for the industry and for the patients it serves — that the leaders in community pharmacy are not reliant on Washington for motivation. The likes of CVS Health, Walgreens Boots Alliance, Rite Aid and Walmart continue to leverage their strengths, including easy access to health care professionals who command broad public trust, even as they expand the scope of services on offer. As long as they stay the course, pharmacy will have a central place in health care.
