We spoke with Stacey Rampy, Principal at Chamber Hill Strategies, about the value of bipartisanship, the current political environment, and what she is tracking as we start the new year.
You have several years of experience working on health care policy, both in Congress and in the private sector. What professional accomplishments are you proudest of?
There are a couple of accomplishments that come to mind. Both have shaped my understanding of how bills with bipartisan and bicameral support have the best chance of becoming law.
For example, I helped a trade association that represents managed care pharmacies convince policymakers to enact legislation clarifying a safe harbor for the pre-approval exchange of health care economic information between payors and pharmaceutical manufacturers about therapies in the pipeline. This information is critical for plans to make timely coverage decisions when new treatments come to
market. Key to our success was the use of a partnership forum to bring together diverse stakeholders to inform our legislative “ask” and convince key Members of Congress and the committees of jurisdiction to intervene with a legislative safe harbor to foster this integral exchange of information.
Another example from my career comes from the more than 17 years that I represented the American Clinical Laboratory Association (ACLA). One of their most pressing issues recently has been addressing a Medicare payment policy that exacts deep cuts to clinical lab reimbursement rates. I helped develop and implement a legislative strategy to convince Congress to delay implementation of that law, and we successfully secured three consecutive delays of that damaging policy.
You mentioned bipartisanship. Tell us more about the value of bipartisanship to achieve success?
I would tell anyone who wants to know more about the value of bipartisanship to look at examples in Congress and in the private sector. When I worked for Rep. Anna Eshoo (D-CA), I saw how she worked with Republicans to advance health policy that she knew would benefit her constituents. When I started my career in multi-client consulting, I worked for a mid-sized bipartisan firm where our best chance of achieving success on behalf of a client centered around a bipartisan strategy. When I decided to strike out and start my own government affairs shop, I knew I would be my most effective with a strong GOP partner. I know Democrats: how they think, how they prioritize issues, and what they care
about. I rely on smart GOP partners to provide insights on Republicans and to help inform my strategy when meeting with Democrats. For example, I’ve adjusted how I approach an issue and which Members to target for support based on what I learn from my GOP colleagues. The bipartisan makeup of Chamber Hill Strategies was a driving motivation for my decision to join the team.
How, if at all, has the political environment changed in DC during your career? How have you adapted to changes to best do your job?
One of the biggest changes I have observed in DC during my career is how the pressure has increased on Members of Congress on both sides of the aisle to tow the party line. In response, I have found that health policy issues often require a diverse group of stakeholders to convince a Member that a policy makes sense for their constituents. It can be more challenging to get a Member to take action, especially if it is something that antagonizes their party’s leadership, or if there is only one stakeholder asking for their support. It is also helpful for stakeholders to be based in the Member’s district or state. Finally, it is imperative to be strategic about which Members you are seeking out to lead an issue. Prioritizing those who sit on committees with jurisdiction over the issue, is paramount and finding those willing to engage their party’s leadership, even if it means bucking it, is also really important.
As we begin the new year, what issue(s) in the health care space do you think are the most important to watch?
The issue that comes to mind for me as being the most important to watch is the use of Artificial Intelligence, or AI, in health care. This issue has been a focus for the White House as well as key committees such as the House Energy and Commerce Committee and the Senate Health, Education, Labor, and Pensions (HELP) Committee. Bipartisan leaders, as well as health care stakeholders, have called for greater regulation given the potential impact on patient safety and security. For instance, concerns have been raised about how the use of AI in health care can lead to discrimination based on certain demographics. So, I think there is going to be a growing focus on this coming from policymakers in 2024.
Can you talk about any experience you have lobbying federal agencies?
I have significant experience lobbying federal agencies, including the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), the Office of Management and Budget (OMB), as well as the White House. I served as the Executive Director of the Essential Health Benefits Coalition (EHBC), an alliance of employers, insurers, and providers, focused on establishing guardrails around the essential health benefits requirement under the Affordable Care Act (ACA). The bulk of our advocacy was focused on senior staff at HHS and the White House.
When lobbying federal agencies and the White House, you generally are dealing with very senior staff, so you need to use those meetings judiciously and be really prepared. You
can’t just depend on talking points and you need to be ready to answer questions on deep policy considerations. The use of reliable and meaningful data to support your position can be enormously helpful, and often required, in order to convince them to take action on your behalf. Finally, unlike lobbying before Congress, you can’t rely on arguing that a policy will be beneficial to constituents in a specific state or district because federal agencies and the White House have a national constituency. You really need to depend on the merits of the argument for the policy itself.
Are there any other things you think clients or prospective clients should know?
I would want clients and prospective clients to know that even though I am, first and foremost, a health care policy and advocacy specialist, I do have experience in other areas as well. I have worked on behalf of health care clients who do not have representation on other issues, such as those related to tax and education. I have also worked on appropriations both on off and Capitol Hill. I have used both the community project funding (or earmark) process and accompanying report language to achieve policy victories on behalf of clients. For example, I employed the community project funding mechanism to achieve $10 million in programs for a leading academic medical center in FY 2023.