Issa aims to unmask health care deals

A top House Republican is investigating the legislative deals the White House and Democratic leadership cut with special interest groups while crafting the new health care reform law. And California Rep. Darrell Issa is not happy with the American Medical Association’s terse response to his questions.


Issa, the ranking Republican on the House Oversight Committee, sent letters to five special interest groups, most of which supported reform and cut deals with the Democrats.


“Contrary to the president’s oft-stated goal of transparency, the rank-and-file members of the Democratic Caucus and the entire Republican Conference have not had the opportunity to participate in the negotiations between the Democratic leadership, the White House and health care stakeholders. This is troubling to members of Congress who value transparency in government,” Issa wrote to the AMA, AFSCME, the U.S. Chamber of Commerce, the American Hospital Association and PhRMA.


Issa asked the groups to detail the health care meetings they had with White House and Democratic congressional leadership officials, what benefits they won from the negotiations and what they were required to provide in return.


PhRMA, the drug industry’s powerful Washington lobbying group, cut a $90 billion deal with the White House and Senate Democrats. The AHA and the hospital industry cut a $155 billion deal with Democrats to help pay for reform. The union AFSCME successfully lobbied the White House to soften the tax on high-end insurance plans. The Chamber had multiple meetings with White House and congressional staffers, but ultimately opposed the legislation.


The AMA, one of the nation’s most prominent doctors’ groups, was a big supporter of reform even though its No. 1 priority — a permanent solution to looming annual cuts to doctors’ Medicare reimbursements — was eventually stripped from the legislation. The so-called doc fix was stripped from the bill because of its expense, but Democrats have repeatedly promised to address the problem this year.


The doc fix’s unfinished status may help explain AMA’s two-paragraph response to Issa’s questions. AMA president James Rohack told Issa his group lobbied, but not much else.


“Such advocacy has always been in the constitutionally protected tradition of petitioning government and elected representatives for redress and has not resulted in any ‘pre-arranged deal or agreement’ or other inappropriate quid pro quo,” Rohack wrote to Issa.


Issa spokesman Kurt Bardella blasted the AMA’s response calling it “totally unacceptable” and “incomplete.”


“If everything that happened is justifiable and defendable, they really should have no issue in providing us with answers,” Bardella said. “One way or the other, we’re going to get answers to these questions.”


Issa will send another letter to the AMA asking for more complete answers. And if need be, Bardella said, Issa will explore deposing or subpoenaing the AMA or any other group that does not provide sufficient answers.


An AMA spokeswoman fired back, saying, “We’re troubled that this comment came via a reporter and not directly from the congressman’s office, and, while we stand by our letter, we would be pleased to continue our ongoing dialogue with Rep. Issa.”


The group supported health reform because it improved the system, but she said the AMA is still working for a permanent doc fix.


Of the five groups, the AMA and the Chamber have responded to the committee, Bardella said.

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