2016 Elections November 10, 2016 Grant Couch, Director, Government Relations Christina Lavoie, JD, Assistant Director, Public Policy and Operations Jamie Miller, MBA, Director, Government Relations
Presentation Outline Election Results White House Senate House Key Players in White House and Congress White House/Congressional Agenda Impact on AMGA Members AMGA s Advocacy Efforts 2
Elections 2016 3
2016 Election Results White House Donald Trump wins the electoral college with 279 votes 2016 Electoral College map Reported as of November 9 th at 1:09 pm Hillary Clinton Donald Trump CA 55 OR 7 WA 12 NV 6 ID 4 UT 6 MT 3 WY 3 AZ* 11 NM 5 CO 9 ND 3 SD 3 NE 5 KS 6 OK 7 MN 10 GA MS AL 16 6 9 DE 3 AK TX LA 3 38 8 MD 10 IA 6 MO 10 AR 6 WI 10 IL 20 IN 11 MI* 16 KY 8 TN 11 OH 18 WV 5 SC 9 PA 20 VA 13 NC 15 VT 3 NY 29 ME 4 NH* 4 MA 11 RI 4 CT 7 NJ 14 Hillary Clinton (D) Running Mate: Tim Kaine Popular Vote: 47.7% States Carried: 20 + DC Donald Trump (R) Running Mate: Mike Pence Popular Vote: 47.5% States Carried: 30 HI 4 FL 29 DC 3 4
2016 Election Results Senate Democrats gain in Senate, Republicans maintain majority 2016 U.S. Senate election results map Democratic winner Republican winner Runoff will be held on Dec. 10 WA OR ID MT WY ND SD MN WI MI VT NY ME NH CA NV UT AZ CO NM NE KS OK IA MO AR IL MS PA OH IN WV VA KY NC TN SC AL GA MA RI CT NJ AK TX LA DE HI FL MD DC 5
2016 Election Results Senate Republican party wins a majority in the Senate Control of the 114 th vs. 115 th Senate Democrats Republicans Independents Not yet called Control of the 114 th Senate (2014-2016) Control of the 115 th Senate (2016-2018) 44 54 45 51 44-2-54 46-2-51 Republican Senate Majority Republican Senate Majority *Louisiana Senate race not yet called, NH likely Democratic
2016 Election Results House Democrats gain net 6 seats, Republican maintain majority 2016 House election results map Democratic winner Republican winner Not yet called 7
2016 Election Results House Republicans retain control of House; limit Democratic gains in 2016 elections Control of the 114 th vs. 115 th House Democrats Republicans Independents Not yet called Vacant Control of the 114 th House (2014-2016) Control of the 115 th House (2016-2018) 218 Needed for Majority 218 Needed for Majority 186-246 193-238 Republican House Majority Republican House Majority *As of 1:27PM on Nov. 9, three House races have yet to be called 8
President-Elect Trump s Inner Circle 9
House Leadership Speaker Paul Ryan (R-WI) His healthcare priorities Medicare solvency Entitlement reform Premium support Repeal ACA Better Way document Prove he can govern His Future as Speaker? Can we all get along? Minority Leader Nancy Pelosi (D-CA) Her healthcare priorities Protect ACA Protect Medicare Advocate for public option 10
House Healthcare Committees House Ways and Means Committee Full Committee Rep. Kevin Brady (R-TX) Chairman Brady s Priorities Tax reform Repeal ACA Entitlement reform Rep. Sander Levin (D-MI) Ranking Member Levin s priorities Protecting ACA Protecting Medicare 11
House Healthcare Committees House Energy and Commerce Committee Full Committee Rep. John Shimkus (R-IL) or Rep. Greg Walden (R-OR) for Chair Their priorities MACRA Implementation Repeal ACA Medicaid Reform Telehealth 21 st Century Cures Rural health (Walden) Rep. Frank Pallone (D-NJ)- Ranking Member Protect ACA Public Health Children s Health Insurance Program (CHIP) 12
Senate Leadership Majority Leader, Sen. Mitch McConnell (R-KY) Healthcare priorities Healthcare in Kentucky Will remain Majority Leader in Senate Supreme Court Minority Leader, Sen. Charles Schumer (D-NY) Healthcare priorities Hospital issues Challenges 2018 13
Senate Finance Committee Sen. Ron Wyden (D-OR) Healthcare priorities Chronic care Data transparency Drug prices CHIP Sen. Orrin Hatch (R-UT) Healthcare priorities Device tax repeal ACA repeal Stark Law Data Transparency CHIP 14
Now What? First 100 Days Campaign Promises o Infrastructure/bipartisan o Repeal ACA o Immigration Supreme Court Nomination Executive Orders Outside events 15
Now What? 60 votes generally needed for legislation in Senate But can do reconciliation which needs simple majority Nuclear option (procedure) Dealmakers still in Congress 16
President-Elect Donald Trump s Healthcare Agenda ACA Repeal Modify law prohibiting sale of health insurance across state lines Allow individuals to fully deduct health insurance premium payments from their tax returns Health Savings Accounts Require price transparency from all providers Block-grant Medicaid to the states Allowing consumers access to imported drugs from overseas Allow drug price negotiation 17
President-Elect Donald Trump s Healthcare Agenda ACA will drive broad healthcare agenda Promises to repeal Can t do full repeal, but Republicans have the votes (reconciliation) for partial repeal Targets individual/employer mandate, Medicaid expansion, subsidies, and taxes Off the table o Insurance Reforms o Exchanges Executive Orders Regulations 18
Healthcare Agenda for New Congress and New President (Continued) Replace with what? 19
Healthcare Agenda for New Congress and New President (Continued) Over 17 million could lose coverage as a result of ACA repeal Health industry may make stand to defend ACA Governors 20
Healthcare Agenda for New Congress and New President (Continued) Entitlement Reform MACRA Changes Delivery system reform Value Agenda 21
Healthcare Agenda for New Congress and New President (Continued) Other changes that could occur: Mental health Health extenders Telehealth Chronic Care ACO fixes 22
Healthcare Agenda for New Congress and New President (Continued) Must Do s in 2017 Debt ceiling around March 2017 Government funding if lame duck Congress passes a shorter funding bill Begin Budget Reconciliation Process 23
Congressional Lame Duck Agenda Dec. 9, 2016- full year or continuing resolution? Mental health Chronic Care 21st Century Cures Expiring healthcare provisions 24
What Does This Mean For AMGA Members? Potential Dramatic Impact Possible provider and industry cuts Possible loss of insured lives MACRA implementation CMMI 25
What Does This Mean For AMGA Members? MA ACOs Black/Welch bill Imaging IOAS exception Stark Law changes Medicare part B drug rule 26
AMGA Advocacy Efforts Issues ACA changes APM fixes/risk Legislation MA ACO fixes IOASE GME Part B Drug Rule Staying Engaged Capitol Hill Day in October Continue to stay fully engaged with policymakers 27
Thank you! Questions/Comments Grant Couch (gcouch@amga.org) Jamie Miller (jmiller@amga.org) Christina Lavoie (clavoie@amga.org) Chet Speed (cspeed@amga.org) 28