The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) has issued an election update and its potential implications for healthcare reform and the O&P profession. The update appears below in edited form:
A resurgent Republican Party seized control of the House of Representatives on November 2, but fell short in the Senate, where Majority Leader Harry Reid survived a tea party-fueled challenge to win a fifth term. Republicans more than recovered their large losses from the 2006 and 2008 cycles by claiming the seats of several highly endangered Democrats and winning at least 239 House seats, a 60 seat pick-up as of today with nine races still undecided. Of those nine close races, four show Democrats leading (AZ-8, KY-6, NY-25, and VA-11), three show Democrats losing (CA-20, TX-27, and WA-2) and two are dead heats (CA-11 and IL-8).
Fueled by voter anger about a sputtering economy and the national healthcare reform effort, Republicans made deep inroads in Democratic-held districts from coast to coast, knocking off long-time Democratic incumbents. The number of Democratic seats won by the Republicans tops the 54 seats gained in 1994 during President Clinton’s first term. One measure of just how bad Democratic losses were: at least half the Blue Dog Caucus won’t be back for the 112th Congress. Twenty-two of the 54 conservative Democrats lost on Tuesday, and six more didn’t stand for reelection. Of the 63 incumbent Democrats that lost, 60 of them voted in favor of the healthcare reform legislation. The gains are the GOP’s largest since 1938, when the party captured 80 seats.
With the announcement today that Nancy Pelosi will run for Minority Leader in the next Congress, the Congressional leadership will look much the same as it did this Congress, except with Minority Leader Boehner becoming Speaker of the House, House Republicans in charge, and House Democrats in the minority.
Democrats also lost control of nine gubernatorial races but managed to keep their majority in the Senate despite the loss of six seats. The Senate race in Washington was called today in favor of the sitting Democratic Senator, Patty Murray. The GOP will win in Alaska, whether the race goes to Sen. Lisa Murkowski or her Tea Party challenger, Joe Miller. In another close race not decided until yesterday, Democratic Sen. Michael Bennett eked out a win in Colorado. Majority Leader Reid (D-NV) defeated Tea Party-backed Sharron Angle (R) and will remain Senate Majority Leader in the next Congress as Mitch McConnell will remain Senate Minority Leader.
Republicans picked up several key seats, including Pat Toomey (R) defeating Rep. Joe Sestak (D) in Pennsylvania; Ron Johnson (R) defeating Senator Russ Feingold (D) in Wisconsin; and John Boozman (R) defeating Senator Blanche Lincoln (D) in Arkansas. In open seats, Rand Paul (R) won in Kentucky, defeating Democrat Jack Conway, and Marco Rubio won in Florida, defeating Gov. Charlie Crist (I) and Kendrick Meek (D).
The electoral map for 2012 looks similarly promising for Republicans. Democrats will defend 21 seats, including some members who will face tough reelections such as Senators Claire McCaskill (D-MO), Bill Nelson (D-FL), Ben Nelson (D-NE), and Sherrod Brown (D-OH).
Also, lost in the news about the GOP sweep of the House, were the results that could solidify Republican gains for a decade or more. Big wins in governorships across the country, and stunning victories in state legislatures (the GOP picked up at least 19 state House and Senate chambers across the country, totaling hundreds of seats), mean Republicans will control redistricting in most states. This will help them solidify their gains for years to come.
Impact on Health Reform and O&P Care
Lame-duck Agenda: The GOP’s first order of business in the lame-duck session will be to try to extend all the Bush tax cuts, which expire at the end of December. In terms of deficit reduction, not much can happen until President Obama’s bipartisan deficit reduction commission delivers its recommendations on December 1. Unemployment insurance is another issue that may be addressed by the lame-duck Congress, in addition to the outstanding appropriations bills, both of which may be temporarily addressed through a Continuing Resolution (CR). Congressman Boehner will be pushing to resolve every one of the outstanding appropriations bills by rolling back the clock and adhering to FY 2008 spending levels.
But the most important bill that needs to be passed in healthcare involves another extension of the “doc fix.” In early summer, Congress passed an extension (including a 2.2 percent update) of the Medicare physician fee fix through November 30, 2010, but without further Congressional action, physician payments will be cut by 24.9 percent beginning on December 1 and reduced by an additional 6 percent beginning January 1, 2011. The American Medical Association (AMA) has called for Congress to extend the existing fix for an additional 13 months through 2011. Passage of some form of doc fix offers a potential opportunity for legislation relevant to the O&P profession to be tacked onto that bill. There may also be an opportunity to try to fast-track the Injured and Amputee Veterans Bill of Rights, H.R. 5428, although this is less clear at this point.
Repealing Health Reform: House and Senate Republican leaders including many committee chairmen and ranking members have said that repealing the historic health reform bill will be their top priority. And the day after Democrats’ huge losses at the voting booth, both President Obama and Senate Majority Leader Reid signaled that they are open to tweaking the healthcare law but not to substantially dismantling it.
But due to the cost of repealing many of these policies or programs and facing the likely challenge of potential Obama vetoes, Republicans likely will have little choice but to whittle away at pieces of the reform law, delaying programs, mandated studies, and reports. If they so choose, they may attempt to de-fund the U.S. Department of Health and Human Services (HHS) by prohibiting appropriations from being spent to implement health reform, but that approach will likely draw veto-level opposition. Still, Republicans have made it clear that they will do everything in their power to repeal health reform, including voting to repeal the bill every day in the next Congress to make the point clear.
In the meantime, NAAOP will be working with HHS, the Centers for Medicare & Medicaid Services (CMS), and other federal agencies as they continue to press forward at a furious pace with the issuance of federal regulations implementing healthcare reform. Unless a repeal bill is ultimately successful or the courts invalidate the reform bill as unconstitutional, a large number of regulations that will be critical to O&P patient care in the future will take hold in the months and years to come. NAAOP will continue to make the O&P case, regardless of the ultimate fate of the national healthcare debate.
NAAOP will continue to keep its membership informed of developments as they occur. For more information, visit www.naaop.org or e-mail [email protected]
