ATLANTA — For home care advocates who meticulously build relationships with Washington lawmakers, election days can often mark painful goodbyes to trusted allies. Industry insiders are used to it by now, and with one day to go before the face of Congress may change, there is little to do but make predictions and anticipate the impact.
Polling numbers point to Republican gains, and Seth Johnson, vice president of government affairs for Pride Mobility Products, Exeter, Pa., predicts the GOP will pick up multiple seats in the House and probably seven in the Senate. "It appears as though the Republicans in the House are poised to exceed the 52 seats they picked up in 1994, the last time the Republicans took control of the House from the Democrats," said Johnson. "If that occurs, it will largely be a result of Americans sending a strong signal to Washington that the process used to advance the administration's priorities — such as health care reform — over the last two years is broken and must be fixed so both parties are forced to work together for the common good."
Wayne Stanfield, president and CEO of the National Association of Independent Medical Equipment Suppliers, believes that Democrats will hold on to both the Senate and House once the dust clears, predicting a 53 to 47 advantage in the Senate, and a 223 to 212 edge in the House. "Despite the extreme level of rhetoric, slanted reporting from both sides and the enormous amount of money spent," said Stanfield, "there are still a large number of very tight races, and the polls are too close in many areas."
John Gallagher predicts the House will go to the GOP with a pickup of 53, and "Speaker Pelosi [Rep. Nancy Pelosi, D-Calif.], retires on Wednesday." Gallagher, who serves as vice president of government relations for the Iowa-based VGM Group, thinks the Senate will stay in the Democratic column with Republicans picking up seven to eight seats. "That makes the balance roughly 52 to 48," said Gallagher, "which ensures plenty of gridlock."
One race drawing particular interest from the industry is Florida Democrat Rep. Kendrick Meek's bid for a Senate seat. Meek is well known to providers for his introduction of H.R. 3790, the bill that would repeal competitive bidding, and provider Georgie Blackburn believes that if elected to the Senate he could further the industry's fight against the program. His bill currently has 257 cosponsors in the House but lacks a companion bill in the Senate.
While Meek is locked in a three-way free-for-all for the seat with former Florida Gov. Charlie Christ (recently turned Independent) and Republican candidate Marco Rubio, "I hope he pulls this out of the hat," Blackburn said.
She's also rooting for Rep. Jason Altmire, D-Pa., to retain his seat. In a year in which all incumbents are feeling the heat, Altmire voted no on the Affordable Care Act. "It has been a plus in this election, and he's polling well at this point," reported Blackburn, vice president of government relations and legislative affairs for Blackborn's, Tarentum, Pa. "We need him in Congress, we need him in leadership and we certainly need him to further our position with competitive bidding. It will be devastating if he is ousted," she said.
What will it all mean for providers if Republicans make gains as predicted? Johnson concludes it is important to have a divided government to keep political parties and branches of government in check. "The Republicans gaining control of the House, assuming they do, will provide a necessary balance of power, which is not only good for the industry but for the country," he said. "If the health care reform legislation had advanced within a divided government, I am convinced the process would have yielded a much better outcome."
If Republicans take control of the House, Gallagher said it "should help" because Rep. John Boehner, R-Ohio, current Minority Leader, will likely become the Speaker of the House. "He is no friend of competitive bidding or CMS," Gallagher said. "To that degree, it is a positive. Republican control will also mean a desire to repeal, or cut funding for, health care reform … That, too, is a positive for the DME industry because the health care law included an increase of an additional 21 competitive bidding area locations and the manufacturer excess tax, among other things, that were detrimental to our industry."
Regardless of who wins control after tomorrow's elections, Gallagher believes the mood will be to cut spending and the deficit. Entitlement spending reduction will be front and center, and that means more Medicare and Medicaid cuts are extremely likely.
When Congress returns in mid-November, Gallager said, "We as an industry must promote the idea that our small sector of the Medicare budget saves the government billions by allowing mom to stay at home and not in a home. "We must make the case that competitive bidding is about the end of hundreds and thousands of jobs. We have got to talk jobs between now and January 1 during the lame duck session."