The Affordable Care Act (ACA) was a tremendously significant piece of health care legislation, particularly for hospitals that had much to gain—or lose—depending on the type of reforms implemented. Today, the health care industry accounts for one-sixth of the U.S. economy, with hospitals consuming nearly one-third of that spending. The recent growth in health care costs is draining the federal budget, and the government has made it clear to the health care industry that the rise in health care spending is untenable and unsustainable for its health care programs, such as Medicare.
Consequently, hospitals are under increasing pressure to cut costs and control spending. This reality, combined with the struggling economic climate, has made hospitals particularly concerned about how health reform will affect their bottom line. Thus, the American Hospital Association (AHA), the national organization that represents nearly 5,000 hospitals and health care networks in America, as well as 40,000 individual members, has a clear vested interest in health care reform, as it could change everything from hospital administration to patient care delivery to profitability.
Since 2008, the AHA has made sure to involve itself in the policy details of the ACA, as well as the political process that led to its passage. In 2009, the AHA spent more than $7 million dollars on its Washington lobbying campaign, ranked near the top spending in the industry. Tom Nickels, the AHA's senior vice president of federal relations, heads a team of 28 lobbyists, and the AHA also makes significant contributions to members of Congress and congressional candidates. In 2008 and 2010, the AHA contributed more than $2 million in each year to candidates, with more than $1 million going to Democrats, according to data from the nonprofit Center for Responsive Politics. In addition, Richard Umbdenstock, president and CEO of the AHA, frequently visited the White House in 2009 in the months leading up to the ACA’s passage.
With so much at stake, the AHA ultimately positioned itself as a partner in health care reform. After a series of negotiations, the AHA, along with two other hospital associations, agreed to accept $155 billion worth of cuts in Medicare reimbursements and other payments throughout the next decade in order to help the government fund other reforms. Recently, Umbdenstock commented on the final legislation, saying, “We supported it, imperfect as it is. Now it is much more important to build on it and improve it.”
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