With the 2016 election over, and President Elect Trump and a host of Republican lawmakers coming online to dominate the House and Senate, the legislative chessboard will be completely reset for the 115th Congress, and the HME industry’s legislative experts are taking stock of the situation.
For the immediate near term, AAHomecare President and CEO Tom Ryan reminded providers that they need to focus on the industry’s immediate lame duck legislative push, adding that “We need relief now — Congress must act!”
“The Congress’ lame duck session will still have to address the large budget issue, which is the prime candidate for a vehicle for our priorities,” added Cara Bachenheimer, senior vice president of Government Relations for Invacare Corp. “We need to stick to the same game plan: make sure every member of Congress is informed about the impacts of the bid program and bid prices in his or her community to maximize the political will to get the relief we are seeking.”
But for John Gallagher, vice president of VGM Government Relations, “a Donald Trump presidency along with the many congressional wins throughout the country was the best case scenario for the DME industry.”
Reason being is that Trump pledged to reduce government regulation and Gallagher said he expects healthcare will fall under that agenda, and with many DME champions returning to Congress, this present the industry with an optimal scenario for beating back competitive bidding.
“The amount of regulation that has crippled businesses across the economy, including DME, will quickly be addressed by the GOP-controlled Congress with Trump sitting in the oval office,” he said. “…As Sen. Rand Paul (R-Kent.) said [Wednesday morning] on Morning Joe, ‘I think you will find that [Congress] will put on Trump’s desk repeal of regulation after regulation, and I think you will see him sign them.’ CMS has continued to force regulations on independent businesses that are harmful for jobs and patient access. These harmful rules and regulations have been on the radar of Congress for the past few years and with a Trump presidency, businesses will have the opportunity to thrive.”
Besides competitive bidding, the big picture scenario when it comes healthcare policy is, of course, the Affordable care Act (ACA), which Congress has tried to repeal dozens of times. The ACA includes the provisions that resulted in the national expansion of competitive bidding.
“… The repeal and replacement of Obamacare, which DME was used as a pay-for, will be front and center and something that will open up great opportunity for long-term reforms in the industry,” Gallagher said.
That said, the fate of bid expansion as part of the ACA, still remains uncertain despite any Congressional and Executive desire to do away with the Act.
“…It depends,” Bachenheimer said. “Republicans’ previous attempts to repeal that law were not comprehensive, but directed at the individual and employer mandates, the exchanges etc. They did not include repeal of the ‘savings’ provisions, which is where our few issues lay. We don’t know yet whether those would be added to an ACA repeal package. It certainly could provide some opportunities for us, but again, we’ll need to time to conduct a more thorough assessment, talk with our Congressional allies about what’s feasible or not, and then figure out our plan of action.”
Besides bidding, another key issue is protecting complex rehab items from bidding. In that regard, there is both a near- and long-term strategy, according to Don Clayback, executive director of the National Coalition for Assistive & Rehab Technology (NCART).
“The elections should not negatively impact our lame-duck chances for legislation to stop the CRT Accessories cuts,” Clayback said. “The good news is all of our CRT champions that were up for election were reelected. We will be talking to our CRT champions and committee staff as we move through next week to see what Congressional leadership plans to take on before year-end.
As to the incoming administration and congress, Clayback is reserving judgment on what that will mean for advancing the interests of CRT until he can see which appointments will be made in the new session.
“… The most important news is our CRT supporters in Congress will be there next year,” he says. “Of our current collective co-sponsors of over 200 Members on our CRT legislation, only 4 will not be in Congress next year. That bodes well for continuing to build CRT awareness and support.
“Discussions On Changes To The Affordable Care ACT and other health care coverage changes will need to be closely watched and we need to be sure people with disabilities are protected, not harmed,” he added.