‘Huge influence’

Lobbyists say that the Republican Caucus of Doctors has a high level of influence in the Republican Party meeting, and its members are committed to solving some bipartisan health policy issues. Modern healthcare allows some lobbyists to remain anonymous, and they want to speak frankly without jeopardizing their relationship on Capitol Hill.

“On the Republican side, I always think that the doctors’ caucus has such a huge influence on health policy that they even made bills that have become laws,” said a lobbyist representing multiple departments. Industry.

For example, when Republicans controlled the House of Representatives in 2015, Rep. Michael Burgess (R-Texas), OB/GYN and the core team played a key role in repealing the sustainable growth rate formula and establishing a new way of paying doctors through the Medicare and CHIP Reauthorization Act.

Senator Bill Cassidy (R-La.) was one of the leaders of the Republican Party to abolish and replace the ACA in 2017. Although this strategy failed, President Donald Trump borrowed some ideas from gastroenterologists and tried to implement them through regulatory means.

Doctors also actively participated in the accidental billing ban passed by Congress last year. The final product is considered provider-friendly, and several doctors serve on committees that help draft legislation. Congressional doctors are currently opposing the Medicare and Medicaid Services Center, which is responsible for implementing the law, because they have proposed regulations that they believe are too friendly to insurance companies.

Another lobbyist said that when Republican leaders need to test the health care policy, their first stop is the Republican doctors’ caucus. Lobbyists say that their strength comes from their numbers, but it is also one of the best-organized pre-election meetings in the House of Representatives. Many congressional caucus basically exist in name, but the Republican doctor caucus actually meets with outsiders, issues policy statements and helps pass bills.

A lobbyist who has worked in multiple industries added that Democrats usually don’t care about the professional background of their members. The lobbyist said that Republicans pay more attention to the medical experience of legislators, which makes them important ambassadors for the conference in terms of health policy.

Several Republican doctors serve on the committee that writes the health care law. Burgess served as chairman of the House Energy and Business Health Subcommittee for several years, for example, in 2017 when the Republican Party tried to abolish the ACA. Three of the four Republican doctors in the Senate — Cassidy, Marshall, and Paul — are members of the Senate Committee on Health, Education, Labor, and Pensions. Republican Senator John Barasso (Wyoming) is a plastic surgeon, and Cassidy is a member of the Senate Finance Committee.

Bipartisanship

Although Republicans are a minority in both houses, they are likely to win back a majority in 2022, allowing the Republican caucus of doctors to stand at the forefront of health care policy making.

The last time the Republican Party had a majority, they tried to abolish the ACA, prevent Medicaid grants and restrict abortion. The party successfully abolished the ACA’s personal authorization penalties, triggering a lawsuit from Republican state officials threatening to eliminate the ACA, but ultimately failed in the Supreme Court.

When the core team succeeds, it is usually on less controversial issues, such as doctor reimbursement.

Burgess said this drives a large part of the core team’s work. “Most of the people we are working now come to this place from private clinics, where we run our own clinics and are responsible for our own recruitment and dismissal decisions,” he said.

This is why Republican doctor legislators are the first to ask for help when some lobbyists need help with payment and practice issues. “If you are a provider dealing with (administrative) burdens on the front line, those with this experience are most helpful,” said a provider lobbyist.

Rep. Brad Wenstrup (Ohio Republican Party), a podiatrist elected for the first time in 2012, recalled that every year he was frustrated by the upcoming cost cuts by the sustainable growth rate policy.

“Congress keeps telling doctors across the United States: continue to see doctors, pay employees and pay bills,” Winstrup said. “Some income has to come in. We have to get credit. I don’t know everyone in Washington understands this.”

Rep. Ami Bera (California Democrat) said that he has got some bipartisan support on some minor health care issues. He is a physician and he is working with Rep. Larry Busson (R-Ind.) is a cardiothoracic surgeon who promotes medical insurance salary increases.

Bella said: “If you rule out their attempt to abolish the ACA, put it aside, and solve some social problems, we can cooperate in more places.” He said that payment reforms, prior authorization and labor issues are some examples.

Another commonality between Republican and Democratic doctors in Congress is their frustration with increasingly onerous insurance rules.

Wenstrup and Ruiz are enacting legislation to limit “step therapy,” an insurance company policy that requires patients to try cheaper drugs first and then switch to more expensive drugs.

“Dr. Ruiz and I can easily associate this sometimes with the role of patient care,” Winstrup said. “Some people decide what treatment they should receive without seeing a patient before. This doesn’t seem appropriate.”

These bills may not advance next year, but the imminent mid-term and post-election “lame duck” meetings may mean that Congress shifts to bipartisan priorities.

Specialty and primary care

Unlike most American doctors who work in primary care, family medicine, or pediatrics, almost all Republican doctors serving in Congress are experts. But these lawmakers do tend to represent the political views of most professional practitioners: According to a 2016 analysis by the New York Times, surgeons, anesthesiologists, urologists, and other experts are more likely to become registered Republicans.