Under the Influence: Money and Power in Politics

More Questions Than Answers One Year After Health Reform

One of many signs held high at a rally for health care reform in Seattle in May 2009. The Affordable Care Act had not passed yet. (seiuhealthcare775nw/Flickr)Health care is one of the most important issues for seniors. After all, older people tend to have more expensive illnesses, more pre-existing conditions, and often have to pay more for insurance. So it should come as no surprise that AARP, with more than half of its members under 65 and not yet eligible for Medicare, is one of the largest supporters of health care reform.

In 2009 the organization hired more than 50 lobbyists to push for the passage of the Affordable Care Act, according to the Center for Public Integrity.

The bill passed and was signed into law in March of last year. Those in Congress opposed to what they call ObamaCare immediately vowed to repeal it, but that's no longer the main concern for AARP.

The organization has stopped trying to influence legislators who want to repeal the Affordable Care Act, because even if such legislation passed, President Obama would likely veto it, said Nora Super, director of government relations for AARP.

"Some of this is political rhetoric, so we want to make sure that we are not mobilizing for something that is not really serious," Super said.

Instead, the battle has moved from floor action on the bill itself to the committees in control of financing it, she said.

"In the funding fight that's going on right now, the Republicans have a proposal in the House that would no longer fund implementation of the state exchanges," she said. "We feel we need to keep funding the implementation or it would be difficult to get the state exchanges going in 2014," the year when they are scheduled to start up.

Funding health care reform was a major issue in getting bi-partisan support to pass a budget earlier this month. According to the Los Angeles Times, Republicans agreed to vote separately on a budget for health care and environmental issues in order to pass a budget that would prevent a government shutdown. Until both parties come to some kind of an agreement, the threat of defunding health care is still on the table.

And not funding health care reform would be the equivalent of repealing it.

"People have long-term care insurance needs," Super said. "Repealing health reform isn't going to make that go away."

Despite the fact that many provisions of the Affordable Care Act won't go into effect for three more years, AARP is already seeing positive effects for its members.

"One of the most important things is it will no longer allow insurance companies to deny based on pre-existing conditions and it also strictly limits the amount you can be charged based on your age," Super said.

Among other things, the bill extends Medicare for 12 more years and closes the so-called doughnut hole, or the Medicare Part D coverage gap, which provides prescription drug coverage for seniors.

Yet many Americans are more confused than ever about the topic of health care reform. According to a Kaiser Foundation Survey, 22 percent of Americans believe the Affordable Care Act was repealed, while another 26 percent admit they don't know enough to say whether it is still law.

To help eliminate some of that confusion, AARP is working on a project called the Health Care and You Coalition. Its goal is to educate people on the ways health care reform affects them as each portion of the act is implemented over the next few years.

"We are working to still defend the bill, and we recognize that it is not perfect," Super said. "There are things about it that can be improved but we certainly don't think it should be repealed."

Though it's still unclear how much AARP is prepared to spend in this round of the fight, the organization last year spent more than $22 million lobbying on about a dozen issues, including health care.

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