Fighting for ObamaCare

Chip Kahn has helped hospitals beat back multiple attempts by congressional Republicans to repeal ObamaCare, but he isn’t ready to declare victory yet.

Kahn, the president and CEO of the Federation of American Hospitals (FAH), says making sure as many Americans as possible have health coverage helps hospitals as well as their patients.

{mosads}“The common theme for me has been — how can we get the most coverage for the most people in the right way,” Kahn told The Hill in an interview in his Washington, D.C., office this month.

It’s a goal that he thinks should bridge the political divide, but the Trump administration and GOP lawmakers aren’t giving up on their years-long goal of weakening and undermining the Affordable Care Act (ACA).

“At the end of the day, hospitals are so important for all the patients of America. We deal with people at their most vulnerable. I don’t think it matters what administration it is, they’re going to want to have fair policy … to make sure the beneficiaries are properly taken care of,” Kahn said.

Kahn, who grew up in New Orleans, is a D.C. veteran who has worked on Capitol Hill and in the private sector since 1974. He was a health-care adviser to then-Sen. Dan Quayle (R-Ind.), and served two separate stints as a senior staff member on the House Ways and Means health subcommittee.

He’s also a former insurance lobbyist, and says there isn’t much about the health-care debate that can still surprise him.

“I guess I’ve sort of seen it all over that period,” Kahn said. “It does seem like Groundhog Day sometimes, because a lot of issues seem to come back. Sometimes they have new names, but there’s not that much new under the sun in terms of what people are trying to do, in terms of health policy.”

The walls of Kahn’s office are adorned with photos and newspaper clippings reflecting some of the major legislative initiatives he’s helped to pass, including the Health Insurance Portability and Accountability Act and the Medicare provisions of the Balanced Budget Act.

He has been leading the FAH, a trade association that represents large, investor-owned health systems, since 2001. 

Kahn is no stranger to the politics of health care, and he says the Republican outrage over ObamaCare was not surprising.

“Post [2009–2010], ACA became a political metaphor in a lot of ways and was the great political divide. It was an important symbol for Republicans,” Kahn noted. “I think that the fundamental politics of financing ACA and the breadth of ACA clearly didn’t work for Republicans.”

Earlier this year, three Senate Republicans broke with their party and voted against a bill that would have repealed the heart of ObamaCare. Tens of millions of people were projected to lose insurance under the GOP plan.

During the repeal effort, health industry and patient advocacy groups worked together in an unlikely alliance to try to save the law. Those efforts continue today, as they are trying to stop Senate Republicans from repealing the law’s individual mandate to help pay for their tax-overhaul legislation.

Kahn said since the groups have a similar goal of trying to ensure more people have health insurance coverage, it’s not surprising that they are working together. Even the insurance industry, which in 2009 secretly spent tens of millions of dollars on an anti-ObamaCare ad blitz to try to defeat it, is now on board with trying to save the law from repeal.

In the early years of the Clinton administration, Kahn helped teach Democrats an important lesson in making sure their reform efforts had the full support of the health-care industry.

As leader of the insurance industry’s lobbying group, Kahn was the brains behind “Harry and Louise,” one of the most notorious health-care ad campaigns, which ran in 1993 and 1994. The ads featured a middle-aged couple sitting around a kitchen table, lamenting the extra costs and loss of choice they would allegedly be left with if then-President Clinton’s proposal became law.

The ads almost always ended with the phrase that would become the insurance industry’s rallying cry: “There’s got to be a better way.”

“The problem with ClintonCare wasn’t what they were trying to accomplish, it was the way they were trying to do it,” Kahn said. “ClintonCare was top-down policymaking.”

“Harry and Louise” were brought back in 2009, this time in support of ObamaCare.

Kahn, who lives in Arlington, Va., with his wife and three sons, said the coverage gains from the law balance out the financial hit that hospitals would have to take in order to pay for it. For that reason, he supports it.

In the years since ObamaCare was passed, Kahn said hopeful expectations about the law haven’t completely been met. But he says it hasn’t been a failure, either.

“ACA was a building block approach to coverage … all the building blocks didn’t fall together the way they were supposed to,” Kahn said, citing the Supreme Court’s decision to make Medicaid expansion optional, as well as the disappointing rollout of healthcare.gov.

“On the other hand, unquestionably, the lives of many Americans have been improved by the coverage they have today which they didn’t have previously.”