With a new Congress and a new presidential administration about to begin, there will be many changes and opportunities ahead for the chiropractic profession. Following is a short summary of the congressional transition, and what it may mean to us as we move forward into the 115th Congress.
While there are three undecided races in Louisiana (a Dec. 10 runoff will determine the final freshman senator, and two representatives are all expected to go Republican), broadly not much has changed in regard to control of the House and Senate. Democrats gained an additional two senators and six representatives; however, this was short of the numbers needed to take control of either chamber, which remain in Republican control under the leadership of House Speaker Paul Ryan (Wis.) and Senate Majority Leader Mitch McConnell (Ky.).
In addition, as a result of retirements, candidacies for other offices and the passing of a handful of members, seven new senators and 57 representatives will take the oath of office on Jan. 3, 2017.
Looking at the departures, we can certainly expect some major changes as both the House and Senate saw the exit of significant policy leaders. In the House, the Committee on Energy and Commerce (E&C) will see significant change, as Chairman Fred Upton (Mich.) is stepping down due to term limits imposed by the Republican Party. Vying to replace him are two senior members of the committee, Reps. John Shimkus (Ill.) and Greg Walden (Ore.). Additionally, with the retirement of E&C Health Subcommittee Chairman Joe Pitts (Pa.), there will be a new subcommittee chairman on this vital committee.
At the Committee on Ways and Means–the other critically important House health committee–there are also some big departures, especially on the Democratic side of the dais. Rep. Charlie Rangel (N.Y.), a legendary policy figure, is leaving after a remarkable 46 years serving in the House, and Rep. Jim McDermott (Wash.), the ranking Democrat on the Health Subcommittee, is leaving after 28 years. For Republicans, Rep. Charles Boustany (La.), a notable member of the House Doctors Caucus, left to run for Senate.
In the Senate there is generally much less turnover, and this election was no different; however, the Senate Committee on Finance saw the departure of Sen. Dan Coats (Ind.) and the Committee on Health Education Labor and Pensions (HELP) will have two vacancies with the departures of Sens. Mark Kirk (Ill.) and Barbara Mikulski (Md.).
The replacements for the outgoing members will be determined in the next few weeks. As these four committees have great sway over issues of importance to the chiropractic profession (such as a repeal and replacement of the Affordable Care Act and overhaul of the Medicare program), we will watch with much anticipation as the process unfolds.
Turning to the congressional agenda, it seems obvious there will be major changes to the Affordable Care Act– though to what degree is difficult to say at present. Regardless, ACA’s first priority must be protection of Section 2706 of the Public Health Service Act, the “Provider Non-Discrimination” provision we fought so hard to enact.
In respect to Medicare, it appears the House Ways and Means Committee will take a look at doing a serious overhaul of the program, which is also of vital interest to the chiropractic profession. ACA launched a campaign in 2015, the National Chiropractic Equality Petition, to change Medicare regulations and enable chiropractors to practice to the fullest extent of their state scope so they can better meet the needs of their senior patients. More than 30,000 chiropractic supporters have signed the petition to date. Any changes to Medicare could potentially impact this important initiative and ACA’s strategy moving forward.
The Senate Finance Committee will likely continue working on its chronic care initiative, which ACA has been a stakeholder in from its inception.
And with a final rule released Oct. 14, 2016, by the Centers for Medicare and Medicaid Services regarding the final regulations for implementation of the Medicare Access and CHIP Reauthorization Act (MACRA)–the historic Medicare reform law that repealed the Sustainable Growth Rate (SGR) formula last year–there will certainly be a number of areas wherein ACA will continue to work with our congressional supporters, many of whom are returning in the 115th Congress.
While there may still be many health policy unknowns ahead of us, be assured that ACA’s government relations team will be ever vigilant in protecting and promoting the interests of doctors of chiropractic and the more than 30 million patients they serve annually.
Jack Dusik is senior director of federal government relations at the American Chiropractic Association.