Politics

Yellen: ‘I Was Surprised’ By Slow Jobs Creation Pace

Matthew Dobias
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Matthew DoBias
Feb. 11, 2014, 7:26 a.m.

After dec­ades of swat­ting back fed­er­al ef­forts to change how care is provided and paid for in the United States, the Amer­ic­an Med­ic­al As­so­ci­ation found enough to its lik­ing to sup­port the ad­min­is­tra­tion’s long, dif­fi­cult cam­paign to en­act health re­form le­gis­la­tion.

But the good­will the AMA earned in Wash­ing­ton could come un­done by its sup­port of a Re­pub­lic­an Sen­ate can­did­ate run­ning on a “re­peal and re­place” plat­form tar­get­ing the new law.

The AMA and its state coun­ter­part, the Pennsylvania Med­ic­al So­ci­ety, this week con­trib­uted $5,000 to former GOP Rep. Pat Toomey, whose prom­ise to scrap the health law has been a key plank of his cam­paign for the Sen­ate.

The con­tri­bu­tion, coupled with a highly pub­lic en­dorse­ment from the Pennsylvania phys­i­cian group, came as the White House, House Speak­er Pelosi and their al­lies plan to tout the key con­sumer pro­tec­tions in the new law that take ef­fect Sept. 23, ex­actly six months since its en­act­ment.

It also has raised eye­brows among some of the ad­voc­ates for health re­form who stood with the AMA dur­ing a pro­trac­ted le­gis­lat­ive pro­cess.

“From the stand­point of health re­form, this is a very strange thing, and I think it’s really coun­ter­pro­duct­ive to where the as­so­ci­ation has tried to move Amer­ica’s health­care sys­tem,” said Ron Pol­lack, ex­ec­ut­ive dir­ect­or and vice pres­id­ent of Fam­il­ies USA. “To put sup­port be­hind someone who is really work­ing to des­troy the key re­forms that are go­ing to help pa­tients, phys­i­cians and oth­er stake­hold­ers, is a bit astound­ing.”

While the AMA it­self does not en­dorse can­did­ates, fin­an­cial con­tri­bu­tions through its polit­ic­al arm, AM­PAC, are nev­er­the­less telling and fre­quently re­flect the polit­ic­al ten­or found at the grass­roots level.

Over the years, the AMA’s power­ful PAC has skewed con­ser­vat­ive—some­times over­whelm­ingly. But in re­cent cam­paign cycles, the as­so­ci­ation’s con­tri­bu­tions have moved more to the left, show­ing fa­vor to­ward Demo­crats, who for now hold the ma­jor­ity on both sides of the dome.

To be sure, it is not un­com­mon for in­terest groups to share the wealth among Demo­crats and Re­pub­lic­ans dur­ing an elec­tion cycle, es­pe­cially ones that serve a di­verse mem­ber­ship. But the cam­paign con­tri­bu­tion to Toomey, whose pub­lic com­ments seem­ingly run counter to the vis­ible role the AMA took in its qual­i­fied sup­port of the health bill, stands out in part be­cause de­bate over the law is still so fresh.

In Ju­ly, Toomey and his elec­tion op­pon­ent, Rep. Joe Ses­tak, D-Pa., met sep­ar­ately with AM­PAC mem­bers for about an hour apiece. In ad­di­tion, each can­did­ate answered a ques­tion­naire to fur­ther gauge their stance on spe­cif­ic policy mat­ters.

Ac­cord­ing to sev­er­al sources, Toomey won out be­cause of his sup­port for med­ic­al li­ab­il­ity re­form. The AMA and oth­er med­ic­al groups have for years lob­bied for stronger pro­tec­tions against med­ic­al mal­prac­tice law­suits even though Demo­crats — long al­lied with the tri­al bar — have been wary of the ef­fort.

The na­tion­al as­so­ci­ation has re­cently taken heat from some of its mem­bers for fail­ing to se­cure tort re­form meas­ures in the broad­er health over­haul pack­age.

AMA Pres­id­ent Cecil Wilson said that his group would con­tin­ue to sup­port the Af­ford­able Care Act. He said the con­tri­bu­tion re­flects Toomey’s com­mit­ment to chan­ging the laws on in­jury lit­ig­a­tion and also to fix­ing the for­mula Medi­care uses to de­term­ine phys­i­cian re­im­burse­ment rates.

“This would be an easy job if every­one had a 100 per­cent re­cord on is­sues we sup­port,” Wilson said Thursday. “I think the im­port­ant thing to em­phas­ize is that it’s not as simple as one is­sue or the oth­er. It’s a mat­ter of where can­did­ates stand in gen­er­al.”

An­oth­er factor is one of simple polit­ics: While the man­tra of “re­peal and re­place” may play well on the cam­paign stump, few in Wash­ing­ton ac­tu­ally be­lieve it is polit­ic­ally achiev­able. The dif­fer­ence between cam­paign speeches and the ac­tu­al le­gis­lat­ive pro­cess could give some groups enough cov­er to make fin­an­cial con­tri­bu­tions that on the sur­face send polit­ic­ally mixed sig­nals.

While in the House, health pro­vider groups gen­er­ally viewed Toomey as an ally. As a law­maker in 2001, he co-sponsored le­gis­la­tion that gave hos­pit­als and phys­i­cians more re­course in fight­ing back against claims of fraud­u­lent or mis­dir­ec­ted billings.

As one health­care lob­by­ist put it, “He talks the lan­guage of docs.”

For his part, Ses­tak, his Demo­crat­ic rival who voted for the re­form bill, has gained the en­dorse­ment of the Amer­ic­an Nurses As­so­ci­ation. In a writ­ten state­ment, he railed against his op­pon­ent’s re­cord on health care.

“We re­spect the PAC’s de­cision,” Ses­tak’s of­fice said in a writ­ten state­ment. “Con­gress­man Toomey has fought for the in­sur­ance com­pan­ies. He wants to deny cov­er­age to chil­dren in need of care by op­pos­ing [the Chil­dren’s Health In­sur­ance Pro­gram], has worked against in­creas­ing ac­cess to pre­vent­at­ive care and pre­scrip­tion drugs for seni­ors; and has cast the de­cid­ing vote in fa­vor of cre­at­ing the Medi­care donut hole.”

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