How SNF Executives Can Lobby Lawmakers Without Leaving the Building

Fresh off a battle that nearly saw wholesale changes to the Medicaid program, skilled nursing lobbyists say the work isn’t over — and that operators on the front lines can often be the most effective voices in reaching Washington.

One of the primary reasons that Congress came so close to gutting Medicaid as part of Obamacare repeal efforts is that officials simply don’t understand the nursing home industry, American Health Care Association senior vice president of government relations Clifton Porter said during a Wednesday speech at the group’s annual convention and expo in Las Vegas.

“Members of Congress don’t know. And they don’t know because we don’t tell them,” Porter said.

In a wide-ranging talk about the past and future of health care reform on Capitol Hill, Porter and other members of AHCA’s legislative team emphasized the importance of regularly inviting lawmakers to SNFs and other long-term care facilities. That way, the next time talk about funding cuts swirls around Congress, the first thing that the representative or senator will think about is the people on the front lines.

“That person’s going to call you before they make a decision,” Porter said. “That’s effective lobbying. That’s the stuff that matters.”

Porter also pointed to a member facility, Wildflower Court in Juneau, Alaska, that recently hosted Republican Sen. Dan Sullivan. After seeing how the facility operated, Sullivan signed a letter — since joined by multiple other senators and hundreds of representatives — asking the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to reconsider the new requirements of participation for skilled nursing facilities.

“Your member of Congress wants do to what you want them to do. But most of the time, we just don’t ask,” Porter said.

With a contentious 2018 election season fast approaching, AHCA vice president Michael Bassett pointed out that SNF administrators and executives should have no problem finding legislators looking for a photo op and some constituent outreach.

“Use the situation to your advantage. Next year is an election year. They’re not going to say no if you invite them to your facility,” Bassett said.

Divided government ahead?

In a one-on-one interview with SNN, Porter said his organization is keeping a close eye on those upcoming races, in which some analysts have predicted a possible House or Senate flip to the Democrats — or both. While the House stands a better chance of a party switch next fall, with far more Democrats forced to defend Senate seats than Republicans, the potential for a divided government could be a boon for the skilled nursing industry.

That’s because, as Porter explained during the panel discussion, having each party in control of different governmental branches can temper legislative headaches from both sides of the aisle: While Republicans typically favor lower regulations, a plus for AHCA, they also seek to cut entitlement programs such as Medicaid. Democrats, meanwhile, emerged as ardent supporters of Medicaid during the most recent repeal fight, Porter noted, but also tend to support greater industry regulations.

“Divided government, for our sector, is a great thing, regardless of your political proclivities,” Porter said.

And like another speaker at the AHCA conference, Porter warned that the fight over Medicaid isn’t over despite the death of multiple repeal-and-replace bills.

“Will it come back up? Absolutely,” Porter told SNN. “Has there been a resounding message and lesson learned from it all? Yes.”

That lesson: Repealing and replacing Obamacare is a much different issue from reforming Medicaid, and Republicans should think twice before attempting another run at both in the same piece of legislation — though Porter wouldn’t rule out the “entirely possible and entirely nonsensical” scenario of Congress simply trying to revive the same ideas that have failed.

“Conjoining the two created a very, very precarious path to passage, both in the House and the Senate,” Porter said.

Written by Alex Spanko