Election and Legislative Update for Healthcare Providers 2012 Southeast Healthcare Provider Conference September 25, 2012

Transcription

1 Election and Legislative Update for Healthcare Providers 2012 Southeast Healthcare Provider Conference September 25, 2012 Mary Moore Hamrick Grant Thornton LLP Stephanie Kennan McGuireWoods Consulting LLC

2 Campaign story: Referendum or choice?

3 Obama's overall job approval rating February 2009 September 2012 Source: Each result is based on a three-day rolling average.

4 Obama: Right direction, wrong track February 2009 September 2012 Source: Rasmussen Reports, Sep. 2012

5 The unemployment effect on incumbent elections Lost Won *In the two years before Reagan's re-election, unemployment had dropped 3.4%. Source: U.S. Bureau of Labor Statistics Unemployment % 8.1% Obama most recent (Sep. 2012) 8.3% Obama took office (Feb. 2009) 7.5% Carter 7.4% Reagan* 7.3% GHW Bush 6.8% Ford 5.5% GW Bush 5.2% Clinton 3.9% Eisenhower 3.7% Johnson 3.7% Truman

6 It's "the economy, stupid." -James Carville

7 Economic landscape unemployment rate - 8.1% federal budget deficit - $1.1 trillion national debt close to $16 trillion debt ceiling - $16.4 trillion real GDP - 1.5% 2Q2012 consumer spending - 2.0% 2H2012

8 Threats to the U.S. economy Taxmageddon Eurogeddon slow growth China, Brazil, India oil shock October surprise

9 The path to victory Each state's area is proportional to its number of electoral votes. Source: The Cook Political Report Graphic by Peter Bell

10 Congressional election

11 Control of the Senate Either party could win a majority Source: The Cook Political Report, 2012.

12 Control of the House Even if Democrats win every toss-up, it's not enough Source: Cook Political Report, 2012.

13 Expect high turnover: lots of new freshmen in 2013 Number of Freshmen in Congress Distribution of Congress by Tenure NJ Research Forecast: Jan Served more than 6 years Served 2-6 years ? Projected Retirements 46% 34% Open Seats to Date Served 0-2 years 2005 (109 th ) 2007 (110 th ) 2009 (111 th ) 2011 (112 th ) 2013 (113 th ) * 2013 figures are NJ Research forecast based on open seats to date (includes announced retirements), projected retirements, and projected incumbent losses (based on a re-election rate of 90%). Source: National Journal Research, 2012.

14 Changes in health care committees House Energy and Commerce all up; five retiring or running for another office Senate Health, Education, Labor and Pensions (HELP) four up; one retiring

15 More polarization / less incentive to compromise Senate vote ratings *National Journal s Vote Ratings scores members of Congress on selected roll-call votes from the previous year *Members are compared to each other on an ideological scale, from liberal to conservative Source: National Journal, February 26, 2011, Pulling Apart, Ron Brownstein; New York Times, January 14, 2012, Boehner Faces a Restive G.O.P. and New White House Attacks, Jennifer Steinhauer.

16 Fewer outliers, more polarization in House: GOPs voting more liberally than the most conservative Dem (outliers) and vice versa DEM Outliers GOP Outliers Source: National Journal Vote Ratings.

17 Lame duck session

18 Immense pressure for action in a six-week window Source: National Journal, July 2, 2012, Field Guide to the Lame Duck, Nancy Cook.

19 The fiscal cliff Sources: Congressional Budget Office; Bipartisan Policy Center; Eurasia Group.

20 Rates increase during difficult economic times Income 10% 15% 15% 15% 25% 28% 28% 31% 33% 36% 35% 39.6% Estate, gift and GST $5.12M $1M exemption 35% 55% rate Capital gains top rate 15% 23.8%* Dividend top rate 15% 43.4%* * Includes 3.8% Medicare tax