‘Always another round’
“Regulations can be shaped by directly engaging with the agency, or with the White House or Congress as a bank shot to influence the agency’s decision-making,” Mendelson said. And while little is moving in Congress these days, advocacy doesn’t stop. “There’s always another round to be fought if at some point things do open up,” he said.
Such efforts to shape the bill have already had some success. When the administration made the surprise announcement in July that it would delay enforcement for one year of a key requirement that large employers provide coverage to their workers, White House officials said they were listening to businesses that said they needed more time to comply.
But it’s particularly difficult to get things done on Capitol Hill when it comes to the health-care bill.
“Democrats are loath to open up the Affordable Care Act, and Republicans are loath to want to perfect it,” said Rick Pollack, executive vice president of the American Hospital Association, which spent more than $17 million on lobbying last year, according to federal disclosure reports.
Nonetheless, Pollack’s group has a “fix-it” list that it hopes to see acted upon, including getting the government to hold off on reducing payments to hospitals that serve large numbers of low-income and uninsured people. The hospital association argues that because the Supreme Court ruled last year that states can opt out of a planned Medicaid expansion and other factors, there will be more rather than fewer low-income and uninsured people going to hospitals.
Last week, as part of the International Franchise Association’s annual public affairs “fly-in,” about 325 members — including Dunkin’ Donuts, Lawn Doctor and Jiffy Lube owner-operators — met with members of Congress and their staffs to urge them to support legislation that would redefine full time as 40 hours per week.
The franchise group opposed the health-care law, but a spokesman said it has changed its approach.
“We’re dealing in a political reality where the law is not going to be repealed until the political dynamic changes,” said Matthew Haller, a group spokesman.
Scott DeFife, the National Restaurant Association’s executive vice president for policy and government affairs, said there’s growing recognition among those involved of the massive effort required. “People understand that some of these very detailed elements in the law may not jibe,” he said.
The group has also been working with the Treasury and Labor departments to make sure regulations take into account seasonal fluctuations in restaurant employment when determining whether these enterprises are large enough to be required to insure their workers. And while the current guidelines provide some flexibility to restaurant owners, the association would like to see that written into law.
“The implementation of the Affordable Care Act is a three- to seven-year process,” DeFife said. “We’ve been working at this for a couple of years, and we’re going to continue working on it.”