Hopkins GIM: What's New

Will Democrats Pursue a Health Care Agenda in 2007?

The following article comes from the Alliance for Academic Internal Medicine newsletter, AAIM Connection.

By taking control of the House of Representatives and the Senate in the mid-term elections, the Democratic Party has shifted the policy debate to 2007. When it begins work in January under the control of Democrats, the 110th Congress is expected to pursue a different health care agenda than its predecessor. This agenda will include several issues of interest to faculty and staff in departments of internal medicine.

With a gain of 22 seats in the House, the Democrats—under the presumed leadership of Representative Nancy Pelosi (D-CA)—intend to pursue a limited agenda that focuses, among other things, on maintaining “pay-as-you-go” (PayGo) spending in appropriations measures, trying to make health care more affordable for Americans, and authorizing the use of federal dollars for stem cell research. Recent reports also suggest that the new majority leadership intends to hold hearings on Medicare reimbursement and the uninsured population.

However, with Representative Pelosi’s intention to follow PayGo budgetary rules, the health care industry may face reimbursement cuts in the coming Congress. Rick Pollack, Executive Vice President of the American Hospital Association, observed, “If you’re going to spend money [like on extensions for popular tax breaks], you’ve got to cut somewhere.” The expected Chair of the House Ways and Means Committee, Charles B. Rangel (D-NY), announced his hope to erase the five percent cut in Medicare physician reimbursements scheduled to go into effect January 1, 2007; however, he tempered his statement by noting, “I don’t know where we would get the money.” Meanwhile, legislation to reauthorize the National Institutes of Health—sponsored by current House Energy and Commerce Chair Joe E. Barton (R-TX) and passed by the House before the election—is in limbo as questions arise regarding the Senate’s willingness to take up the legislation and how Democratic leadership may influence particular aspects of the bill.

Chip Kahn, President of the Federation of American Hospitals, commented that the transfer of party power will inevitably affect the health care debate because “Democrats are more comfortable talking about health issues.” Yet Mr. Kahn (a long-time advisor to Senate Republicans) and others question how effectively a Democratic Congress will work with President Bush. President Bush is expected to veto legislation on contentious issues such as funding for embryonic stem cell research. However, the close party breakdown prohibits a veto-proof margin, which could prevent a true departure from current policy.

In a 2006 study published in The New England Journal of Medicine, researchers found that the majority of voters in the 2006 midterm elections were influenced by issues such as the war in Iraq, the economy, and illegal immigration rather than a candidate’s stance on health care. The 11 percent of voters who mentioned health care as a pertinent issue focused on cost, access, and the future of the Medicare program. The public’s apathy toward a health care agenda is aligned with Congress’ plan for the next session; while legislation on stem cell research is likely to be reintroduced, the majority of issues to be addressed pertain to national security, the war in Iraq, ethics legislation, and the economy.

Elections for the majority and minority leadership positions in both chambers will be held during the next few weeks. The chairs of committees and subcommittees will be appointed by the House and Senate leadership after these elections. The health care agenda as well as the probability of successful passage of significant legislation will likely depend on who assumes the chair of the relevant committees.