2014 Mid-Term Elections: Impact on Health Care and Medical Groups. November 6, 2014
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1 2014 Mid-Term Elections: Impact on Health Care and Medical Groups November 6, 2014
2 Presentation Outline 2014 Election Results Senate Results House Results Congressional Lame Duck Session The Next Congress: Progress or Stalemate What This Means for Medical Groups
3 Republicans Win Solid Majority in Senate Control of the 114 th Senate ( ) 2 Democrats 2 Republicans 1 Democrat + 1 Republican 1 Democrat + 1 Independent 1 Republican + 1 Independent Undecided/Runoff May take until Nov. 18th to count all votes WA OR NV CA ID UT AZ MT WY CO NM ND SD NE KS OK MN IA MO AR WI IL IN MI TN KY OH PA WV VA SC NC NY VT ME NH MA RI CT NJ DE MD MS AL GA AK AK HI TX LA Runoff election will be held on December 6, 2014 FL Democrats: 44 Republicans: 52 Independents: 1 Undecided: 2 Analysis Having won most of this year s competitive races, Republicans secured at least 52 Senate seats on election night, flipping the Senate from blue to red Additional GOP wins in Louisiana and Alaska are still possible If Republicans eventually expand their majority to 54 seats, they will have an easier time passing legislation in the Senate because they will need fewer Democratic defections to overcome filibusters (which require a 60 vote supermajority) Source: National Journal Research; CNN Election Center; Associated Press; NBC News.
4 Notable Senate Elections Arkansas-Rep. Tom Cotton (R-AR) defeated Sen. Mark Pryor (D-AR) North Carolina-NC House Speaker Thom Tillis (R-NC) defeated Sen. Kay Hagan (D-NC) Georgia-David Perdue (R-GA) defeated Michelle Nunn (D-GA) Iowa-State Senator Joni Ernst (R-IA) defeated Rep. Bruce Braley (D-IA) Colorado-Rep. Cory Gardner (R-CO) defeated Sen. Mark Udall (D-CO) South Dakota-Governor Mike Rounds (R-SD) defeated Rick Weiland (D-SD) Kansas-Sen. Pat Roberts (R-KS) defeated Greg Orman (I-KS) Kentucky-Sen. Mitch McConnell (R-KY) defeated Alison Grimes (D-KY) Virginia-Sen. Mark Warner (D-VA) defeated Ed Gillespie (R-VA) New Hampshire-Sen. Jeanne Shaheen (D-NH) defeated former Sen. Scott Brown (R-NH and MA) Michigan-Rep. Gary Peters (D-MI) defeated Terri Lynn Land (R-MI) Louisiana-Sen. Mary Landrieu (D-LA) and Rep. Bill Cassidy (R-LA) will face a runoff on December 6, 2014 Alaska-The race between Sen. Mark Begich (D-AK) and Alaska Attorney General Dan Sullivan (R-AK) hasn t concluded but Sullivan is expected to win
5 Republicans Win Solid Majority in Senate Control of the 113 th Senate ( ) Control of the 114 th Senate ( ) Democratic Republican Independent Undecided Total Seats Democrats: 53 Republicans: 45 Independents: 2 Total Seats Democrats: 44 Republicans: 52 Independents: 2 Undecided: 2 Analysis Having won most of this year s competitive races, Republicans secured at least 52 Senate seats on election night, flipping the Senate from blue to red Additional GOP wins in Louisiana and Alaska are still possible If Republicans eventually expand their majority to 54 seats, they will have an easier time passing legislation in the Senate because they will need fewer Democratic defections to overcome filibusters (which require a 60 vote supermajority) Source: National Journal Research; CNN Election Center; Associated Press; NBC News.
6 Republicans Win Record Majority in House Control of the 114 th House ( ) Democratic Republican Undecided* AK Democrats: 175 Republicans: 243 Independents: 0 Undecided: 17 Analysis Republicans won a total of at least 243 seats in the House, their largest majority since 1928 An expanded GOP majority in the House means that Speaker Boehner will have an easier time passing legislation in the House without Democratic support, and Republicans will also have an easier time holding on to their majority in future elections * Races not called as of 6am 11/5/2014; includes runoff elections to be held in LA-5 and LA-6 Source: National Journal Research; CNN Election Center; The New York Times.
7 Notable House Elections Notable House Incumbents Losses (FL-2)-Gwen Graham (D) defeated Rep. Steve Southerland (R) (NH-1)-former Rep. Frank Guinta (R) defeated Rep. Carol Shea-Porter (D) (FL-26)-Carlos Curbelo (R) defeated Rep. Joe Garcia (D) (GA-12)-Rick Allen (R) defeated Rep. John Barrow (D) (IL-12)-Mike Bost (R) defeated Rep. Ed Enyart (D) (IL-10)-former Rep. Bob Dold (R) defeated Rep. Brad Schneider (D) (NV-4)-Cresent Hardy (R) defeated Rep. Steven Horsford (D) (NY-1)-Lee Zeldin (R) defeated Rep. Tim Bishop (D) (NY-1)-John Katko (R) defeated Rep. Dan Maffei (D) (TX-23)-Will Hurd (R) defeated Rep. Pete Gallego (D) (WV-3)-Evan Jenkins (R) defeated Rep. Nick Rahall (D) Notable Open House Seat Wins (IA-1)-Rod Blum (R) (NY-21)-Elise Stefanik (R) (NC-7)-David Rouzer (R) (UT-4)-Mia Love (R)
8 Republicans Win Record Majority in House Control of the 113 th House ( ) Democratic Republican Vacant Undecided* Control of the 114 th House ( ) AK Total Seats Democrats: 199 Republicans: 233 Vacancies: 3 AK Total Seats Democrats: 175 Republicans: 243 Undecided: 17 Analysis Republicans won a total of at least 243 seats in the House, their largest majority since 1928 An expanded GOP majority in the House means that Speaker Boehner will have an easier time passing legislation in the House without Democratic support, and Republicans will also have an easier time holding on to their majority in future elections * Races not called as of 6am 11/5/2014; includes runoff elections to be held in LA-5 and LA-6 Source: National Journal Research; CNN Election Center, November 2014.
9 Congressional Lame Duck Session Funding the Government Small House Health Care Bill/Senate Action? Senator s Cruz/Lee Lame Duck Strategy
10 The Next Congress: Progress or Stalemate Boehner/McConnell Now What?
11 Boehner Challenge House Tea Party Caucus Evolving campaign contribution sources Practical to work with Democrats Desire to lead and leave a legacy Rumors of Retirement Lieutenants in Leadership
12 McConnell Challenge Vulnerable Republican Senators in 2016 Senators running for President in 2016 Senate Tea Party Caucus Independent Caucus
13 President Obama Options White House Reaction Cooperate with New Congress Obstruct with Eye on 2016 Prize Ensure Democrats Keep White House Increase Republican Losses
14 Who Are the Health Care Players in Congress? Sen. Orrin Hatch (R-UT) Sen. Ron Wyden (D-OR) Rep. Paul Ryan (R-WI) Rep. Fred Upton (R-MI) Rep. Anna Eshoo (D-CA)/Rep. Frank Pallone (D-NJ) Rep. Sandy Levin (D-MI)
15 What Does This Mean for Medical Groups? Affordable Care Act (ACA) Medicare Advantage (MA) Sustainable Growth Rate (SGR) Repeal Accountable Care Organizations (ACOs) Imaging
16 What Does this Mean for Medical Groups? ACA Symbolic Repeal Vote/Filibuster/Veto Targeted Approach through Budget Reconciliation Individual Mandate Employer Mandate Medical Device Tax Insurer Tax Independent Payment Advisory Board (IPAB) Copper Plans House-Senate Agreement? Replace With What? Veto
17 MA What Does this Mean for Medical Groups? Support Gets Stronger Republican Created Program Bi-Partisan Approach to Call Letter MA Bump?
18 What Does this Mean for Medical Groups? SGR Repeal Sen. Hatch will want Caucus Priorities included Structural Changes as Pay Fors Decrease Pressure on Provider Cuts Rep. Paul Ryan Include his Priorities in SGR Repeal Updates with Cost and Quality Metrics
19 What Does this Mean for Medical Groups? ACOs Bi-Partisan Support ACO Refinement Legislation Being Drafted Elections Have Little Effect on ACOs
20 What Does this Mean for Medical Groups? Imaging Republicans Less Inclined to Open up Stark Law Stark Law a Democratic Policy But, Some Societies Want It/Huge PAC $
21 What is AMGA Doing? Continue to Lobby for the Group Practice Model and MSMG Issues Planning Visits to New Health Care Players on Capitol Hill Increasing Member Engagement with Congress
22 Questions/Comments
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