RURAL HEALTH CARE SYMPOSIUM FEBRUARY 19, 2015

Transcription

1 Hosted Luncheon and Regulatory Update 12:00 1:15 p.m. William J. Emmerson, DDS Senior Vice President, State Relations and Advocacy California Hospital Association RURAL HEALTH CARE SYMPOSIUM FEBRUARY 19, 2015 The Political Landscape, Affordable Care Act and State and Federal Advocacy Priorities for 2015 William J. Emmerson, DDS Senior Vice President State Relations and Advocacy California Hospital Association 1

2 The Mid-Term Election Outcome 113 th Congress 114 th Congress House: D s R s Senate*: D s R s * Two independent Senators caucus with the Democrats 2 California Congressional Delegation in 114 th Congress California Democrats gained one seat from the 113 th for a total composition of 39 Democrats and 14 Republicans Rep. Kevin McCarthy was reelected as Majority Leader, and Rep. Nancy Pelosi remains Minority Leader Key committee memberships: House Ways and Means Committee House Energy and Commerce Committee Republicans Democrats Republicans Democrats Rep. Devin Nunes Rep. Xavier Becerra Rep. Mike Thompson Rep. Linda Sanchez None Rep. Anna Eshoo Rep. Lois Capps Rep. Doris Matsui Rep. Tony Cardenas 3 2

3 Election 2014 Did voters care about deficit reduction? On the stump, old arguments prevailed: Democrats attacked GOP for support of Ryan plan and Medicare cuts Republicans attacked Democrats for supporting Obamacare and Medicare cuts in ACA Voters are okay with divided government Red/blue states until next census and redistricting 4 The ACA and the Election Do you generally favor or oppose the ACA? Favor: 38.6% (41.3%)* Oppose: 51.1% (49.1%)* Source: RealClearPolitics, Public Approval of Healthcare Law, average of public polls, Oct. 1 to Nov. 9, * January

4 The ACA and the 114 th Congress Early push to get a repeal bill to the president Two serious obstacles Senate filibuster No replacement plan Bottom Line: President Obama will veto a repeal bill 6 Possible ACA Targets/Amendments Repeal of the employer mandate Repeal/alteration of the individual mandate Repeal Independent Payment Advisory Board (IPAB) Repeal medical device tax Keep your own insurance plan changes Constrain risk corridor payments Free up states on Medicaid funding/waivers 7 4

5 Another ACA Supreme Court Case King v. Burwell to be heard in early March; decision in June Question of whether subsidies should be available to those in states that have federal exchanges Decision would affect 36 states (not California) that lack their own exchanges, and more than five million people 8 Hospital Budget Vulnerabilities Medicare or Medicaid Savings to: Offset to other program spending Pay for extending the debt limit Extend the life of trust funds Finance entitlement reform Pay for Sustainable Growth Rate (SGR) fix 9 5

6 California 2014 Elections Vacancies Assembly D s R s Vacancy 1 Senate D s R s Vacancy California 2014 Elections Constitutional Officers All Democrats New Senate and Assembly Members Senate 7 3 Vacancies Assembly 26 1 Vacancy 11 6

7 Democrat and Republican Leadership Senator Kevin De Leon (D-Los Angeles) Senate President Pro Tem Senator Bob Huff (R-Diamond Bar) Senate Republican Leader Assemblymember Toni Atkins (D-San Diego) Speaker of the Assembly Assemblymember Kristin Olsen (R-Modesto) Assembly Republican Leader 12 Republican Election Gains Republican election gains reduced the Democrats Super Majority for both houses. Cannot increase taxes without Republican support Cannot place issues on the ballot without Republican support 13 7

8 California Political Reforms Change in term limits 12 years Modified Open Primary Top Two Primary Election Winners Meet in General Election Redistricting Commission Draw Legislative District Lines County Boundaries City Boundaries Communities of Interest CHA-Sponsored Legislation Community Benefits Freestanding Emergency Departments EMS Quality Improvement Data Sharing Psychiatric Treatment and Hospital Emergency Department Overcrowding Reverse of DP/SNF Retroactive Rate Cuts Privacy Breaches Non-Contracted Hospital Default Payments of Local Law Enforcement Agencies Medical Information We Care 4 CA 15 8

9 Register now for our Legislative Day March 10 & 11, Questions? 9

10 Thank you! William Emmerson (916)