Election 2016 Predictions and Impact

Election 2016 Predictions and Impact

Candidates for President of the U.S. ELECTORS OF PRESIDENT AND VICE PRESIDENT CLINTON and KAINE, Democratic JOHNSON and WELD, Libertarian STEIN and BARAKA, Green-Rainbow TRUMP and PENCE, Republican

What issues do voters care about? Pew Research Center, July 16 Economy & Terrorism The economy and terrorism are the top two issues for voters this fall. Overall, 84% of registered voters say that the issue of the economy will be very important to them in making their decision about who to vote for in the 2016 presidential election; slightly fewer (80%) say the issue of terrorism will be very important to their vote. Other issues that rank highly on voters 2016 importance list include foreign policy (75% very important), health care (74%), gun policy (72%) and immigration (70%). With an open seat on the Supreme Court, 65% say appointments to the nation s highest court will be a very important factor in their decision this fall.

Presidential Polls National Polls According to a recent ABC News and ABC News/ Washington Post polls, Hillary Clinton up 12 percentage points over Donald Trump among likely voters, 50 to 38 percent Up 7 points since Oct. 13 CNN Poll out this week has a narrower margin, 5% Polling of Massachusetts Voters Clinton has an over 24% lead in Massachusetts

Six Consecutive Presidential Elections Source: 270towin.com

Electoral College Map Source: 270towin.com

Donald Trump Repeal Obamacare Promises no cuts to Medicaid Convert Medicaid to block grant, ending the open-ended federal entitlement and capping federal funding Enforce immigration laws. Claims U.S. provides healthcare to illegal immigrants, costing $11B annually. Hillary Clinton Expand Medicaid in the 19 states Three years of full federal funding for 19 states (same as originally offered when passed) Allow people ages 55-64 to buy into Medicare

Donald Trump Repeal Obamacare Promises not to Cut Medicare Support drug importation Hillary Clinton Authorize Medicare to negotiate drug prices with Pharma Supports beneficiaries importing lower-cost Rx from abroad Allow people ages 55-64 to buy into Medicare

Donald Trump Nothing in Health Care Plan No response to NACHC inquiry on funding cliff Answer to ACA is to increase funding for more CHCs Hillary Clinton Double funding for CHCs and support healthcare. Double funding for primary-care services at CHCs over the next decade. Supports President Obama s call for a near tripling of size of National Health Service Corps. Favors 3.6B Mandatory over 10 years, 36B, plus additional growth funds

Donald Trump Hillary Clinton Completely Repeal Obamacare Eliminate individual mandate Tax deduction for health insurance premiums. Allow individuals to fully deduct insurance premium payments from their tax returns Allow insurance companies to sell across state lines Allow individuals to use Health Savings Accounts. Price transparency from all healthcare providers, especially docs and healthcare organizations like clinics and hospitals. Defend and Strengthen ACA Resolve family glitch that denies insurance subsidies to some dependents Sweeten Subsidies for people buying coverage in marketplace Offer a new governmentsponsored insurance plan to compete with private companies Hillary Plan to expand coverage to 9 million more uninsured Repeal tax on high-cost insurance Cadillac Tax

U.S. Senate Current Senate Republican 54 Democrat 44 D, 2 Ind. Seats not up for Reelection 30 34 Solid Party Seats +16 +10 46 46

Competitive U.S. Senate Seats Republican Rubio (I) Portman (I) Kirk (I) Johnson (I) Ayotte (I) Florida Ohio Illinois Wisconsin NH Democrat Murphy Strickland Duckworth Feingold Hassan 48 49

Competitive Senate Seats Cont. Pat Toomey (I) Todd Young Richard Burr (I) Pa. Indiana NC Katie McGinty Evan Bayh Deb Ross 48-51 49-52 2018 US Senate?!

U.S. House of Representatives Current House Republican 247 (435) Democrat 188 Solid Incumbent Seats 201 (378) 177 Likely Outcomes +27 (417) +12 228 189 (+5)

U.S. House Cont. Toss Ups: 18 Seats 15 current R (5 open) 3 current D (2 open) Predictions: Dems gain 5-20 Highly unlikely to get 30

In September 2016, a Kaiser Family Foundation Conducted a Health Tracking Poll Favorable or Generally Unfavorable Opinion of Health Reform Bill signed into law in 2010 ( Obamacare )? 47% Unfavorable (down 2% since April) 45% Favorable (up 7% since April) New Government Report on ACA likely to drive up Unfavorability in October

According to Government Report Released on Monday, ACA Costs Surge. Average premium for Benchmark Silver Plan will rise 22% in 2017 in states that use federal exchange Typical bill will be $296 a month for 27-year old Last year, Premiums rose only +7.2% (double pace of inflation) However, 75% of Policy Holders will pay less than $100 per month with Gov t Subsidies 2017, number of Carriers will drop to 228 (down 70) in Federal Exchanges and selected states Insurers narrowing networks to keep costs down

Enrollees Sicker and More Costly than Expected Lack of Young, Healthy Enrollees Insurers Priced Plans Too Low (Adjusting) Fewer Companies Offering Coverage Dropping Exchanges

State of Play in Massachusetts Most lawmakers did not face re-election challenges and even fewer face opponents in 2 weeks 15 of 40 Seats in the Mass Senate Contested 42 of 160 Seats in the Mass House Contested 7 of 14 Sheriffs Contested Legislators on Road for Presidential Candidates

Massachusetts Senate 40 Mass. Senators: 34 D, 6 R 3 Open Seats: Wolf (D): Cyr (D) vs. Schiavi (R) Downing (D): Hinds (D) vs. Canning (R) Joyce (D): Timilty (D) 3 Contested Republican Seats: O Connor, Humanson, Ross All likely to remain 9 Contested Democratic Seats: L Italien (D) vs. Laplante (R) Gobi (D) vs. Erhardt (R) Lesser vs. Harrington (R)

Massachusetts House of Representatives 160 House Members: 126 D, 34 R 9 Open Seats: All current Democratic seats Likely 8/9 will stay D J. Fernandes (D): Biagetti (R) vs. Murray (D) 15 Contested Republican Seats: Likely 11/15 will stay R Wong/Migliore, Decoste/Nyman Viera/Patrick, Boldyer/Sandlin 8 Contested Democratic Seats: Likely 5/8 will stay D Gregoire/Ferro, Mom/Kay Cutler/Cogliano

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State Facing 9c Cuts $294 million gap between anticipated revenue collections for fiscal 2017 and budgeted spending House Speaker and Senate President calling for Baker Administration to pump the breaks Gov. says municipal and school aid, funding for DCF core services, higher ed, court system, DMH, pensions, debt service and budgets of other four constitutional officers off limits Mass Medicaid Waiver Approval Pending Governor 69% Job Approval Rating, but no progress on key legislative priorities (e.g., charter schools)

U.S. House and Senate both put forward $1.5B for discretionary funding FY2016 levels carry forward through CR, back in December to pass budget appropriations

30 Programs expire over next 2 years, largest CHC mandatory funding and CHIP $3.6B out there being used by CHCs No clear legislative vehicle, nothing like Medicaid Doc Fix Fix Options 1. Move $3.6B to discretionary, moves us beyond cap under discretionary funding 2. 10-year fix, considered permanent 3. Kick forward with shorter multi-year fix

Only 2/3 of Massachusetts FQHCs are members of NACHC Expect 50% of Congress to turn over in four years must re-educate members build new relationships

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