A new fight over healthcare reform

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McCain spokesman denies Obama's Medicare claims
McCain spokesman denies Obama's Medicare claims

One of the highlights of the American Association of Homes and Services for the Aging conference came near the end—during a panel discussion about the impact of midterm elections on healthcare reform.

The session came at an opportune moment—one day after the elections that handed the House back to Republicans. (I don't know if it's timing or luck, but AAHSA's conferences always seem to coincide with key legislative events.) Barbara Gay, AAHSA's director of advocacy information, predicted that a repeal of healthcare reform is probably not going to happen, given Democrats' control of the Senate and White House.

It was telling that the AAHSA panel, which was composed of Gay, along with other legislative and policy experts, framed its post-election day discussion around healthcare reform. Preservation of the law clearly is one of the organization's highest advocacy priorities. That makes sense, given AAHSA's work on behalf of the CLASS Act, which will create a disability insurance trust.

AAHSA also stands firmly behind other areas of the statute, specifically the second half of the 2,700-page law. This part may be the richest part of the legislation in terms of improving healthcare with innovations on payment systems and care models, AAHSA Vice President Barbara Manard suggested.

While participants suggested that their programs may encounter some obstacles, they also expressed enthusiasm for advocacy in the face of potential opposition.

“AAHSA wants its friendships on both sides of the aisle at all times,” said Suzanne Weiss, who is retiring as senior vice president of advocacy.

“AAHSA never writes off a session of Congress … and neither should you.” 

When the going gets tough, Weiss suggested, the tough get to Capitol Hill.

A difference of opinion

It is interesting to compare these comments to those made at that the American Health Care Association conference a few weeks ago. The tone regarding healthcare reform at AHCA was decidedly more somber.

During his speech, outgoing AHCA President and CEO Bruce Yarwood said that healthcare reform has not been “good for us so far.” He called it an insurance package that largely neglected long-term care.

He focused on the reduction of $15 billion from Medicare over 10 years in the law. While AAHSA folks spoke with enthusiasm about accountable care organizations and the concept of bundling, Yarwood called bundling a “watch-out piece.” Transparency requirements in healthcare reform, while modified, are also a sensitive spot for AHCA, the largest nursing home advocacy group.

AHCA was not all negative about healthcare reform. David Hebert, senior vice president of policy and government relations at AHCA, noted some reform accomplishments in an education session. These include an extension of the Medicare Part B therapy exceptions process, which expires at the end of the year, and a partial fix for Medicare Part D.

Still, there's no question that AHCA and AAHSA view this law from different perspectives.

Knowing the issues

Paula Zahn's address was another conference high point for me. The polished and informed former CNN anchor spoke warmly and passionately to the AAHSA audience.

While she inspired me as a journalist, her presentation also was powerful because she talked about aging from a personal perspective. Her mother, who resides in an AAHSA-member facility, suffered a stroke a little while back. Zahn and her family had to make difficult decisions about everything from whether she should drive to where she should live.

Ultimately, her mother decided to live in an assisted living facility.

“Concurring with that decision was one of the most wrenching decisions of my life,” she said.

Following her speech, she moderated a panel discussion with providers and a resident about long-term care issues. The conversation was thoughtful and informed. Clearly, Zahn knew her stuff.

Zahn's personal experiences help make her a good spokeswoman for the field. Long-term care groups would be wise to seek out others like her.

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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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