Wednesday, November 3, 2010

Understanding the impact of 2010 mid-term elections

Yesterday during the mid-term elections, the Republicans gained the majority in the House of Representatives and increased representation in the Senate (where they are still in the minority). As the Obama Administration spent ~1.5 yrs of the past 2 yrs implementing health care reform, the Affordable Care Act is (ACA) sure to be targeted. Here are some of the ways family medicine and health care reform may be affected:

One of the campaign promises that Republicans ran on was repealing health care reform, i.e. the Affordable Care Act. The full repeal of the ACA is unlikely since:
(a) any legislation that is introduced and passed in the House by a Republican majority would not pass the Senate and even if it did would be vetoed by the President.
(b) many Republicans were supported financially during the campaign and continue to be supported by special interest groups such as insurers and pharmaceutical companies who stand to benefit from the ACA since there will be increased numbers of individuals insured under ACA

Likely actions to affect the bill:
  • repeal of individual sections of bill that are unpopular with Republicans, moderate Democrats, independents
  • attempts to block funding for new programs and provisions of the ACA
  • attempts to delay implementation of parts of ACA

Other actions that may occur with the new House are:
  • attempt to pass comprehensive tort reform legislation (as promised during campaigning)
  • subpoenaing Don Berwick of CMS and Kathleen Sebelius, HHS Secretary to testify about health care reform process
  • implementing budget cuts to primary care research such as Title VII, NIH and AHRQ funding (Republicans have pledged to cut $100 billion from discretionary spending)

Many of my projections are informed by discussion in my Community Organizing Health Policy class at HSPH; my discussion with Bob Blendon, a health policy analyst; and a memo to members of the Academic Family Medicine Advocacy Committee (AFMAC).

What do other people think? Thoughts or predictions?

1 comment:

  1. Out of all of these things, I agree that tort reform is something that needs more attention at both the state and national level. Some states already have implemented meaningful tort reform (ie Texas) and are able to recruit more physicians.

    As you said, the Republicans have had success in running campaigns based on lowering taxes and decreasing wasteful spending. They can cut $100 billion rather quickly by adding regulation onto the ACA through tort reform and shifting value towards primary care. I see the thousands of dollars spent each hour at the small community hospital I am rotating at right now based solely on defensive medicine and fear - all while putting patients through unnecessary needle sticks and high exposure to radiation.

    As far as research funding, they may very well cut funds towards research. If they understand value (some might), they would shift more funding towards primary care research and less funding towards technology that drives up the cost of medical care exponentially.