As expected, the Republican Party swept to victory in the November midterm elections, securing majorities in both the House and Senate and winning several key gubernatorial races across the country.

Of course, according to the electoral math alone, it was apparent that Democrats faced an uphill battle in November. Of the 36 Senate seats being contested, Democrats had to defend 21, compared with just 15 seats held by Republicans. Going into the election, Republicans held a 33-seat majority (234 seats to the Democrats’ 201 seats) in the House of Representatives, but as few as 15 races were considered truly competitive—partly because of the partisan redistricting process at the state level. Combined with a growing sense of disquiet over President Obama’s handling of certain key issues and a strong slate of Republican candidates, the stage was set for a relatively comprehensive Republican victory.

House Summary

The Republican Party added to its already strong position with a net gain of 12 House seats, leaving the party with a majority of 244 to the Democrat party’s 186. Notably, Republican challengers defeated 19-term Congressman Nick Rahall in West Virginia, ousted fiscally conservative “blue dog” Congressman John Barrow in Georgia, and secured bragging rights in North Carolina by picking up the seat vacated by Congressman Melvin Watt, who resigned from the House to serve in the Obama administration as head of the Federal Housing Finance Agency.

House Committee Update

The election brought about several important changes in leadership of the House committees with jurisdiction over the Medicare program.

Energy and Commerce: Representative Fred Upton (R-MI) will retain his chairmanship, and his committee health care staff are expected to remain largely intact. With both former ranking member Henry Waxman (D-CA) and Chairman Emeritus John Dingell (D-MI) retiring, Health Subcommittee member Frank Pallone (D-NJ) will serve as the ranking Democrat on the committee.

Ways and Means: The chairmanship of the powerful tax-writing committee changed hands, with Representative Paul Ryan (R-WI) replacing the retiring Chairman Dave Camp (R-MI). This leadership shuffle will mean significant changes in the composition of the committee staff. Ryan assembled a strong health care staff as chairman of the Budget Committee, and many expect these staffers to join the Ways and Means Committee. Representative Sander Levin (D-MI) will retain his position as ranking member.

Senate Summary

On the Senate side, Republicans regained control of the upper chamber for the first time since 2008 with a net gain of eight seats. The GOP now holds a majority of 54 seats to the Democrats’ 46 (including two independent senators who caucus with the Democrats) after a runoff election in Louisiana on December 6 when Republican challenger Bill Cassidy defeated incumbent Democrat Mary Landrieu.

Notable Republican victories included a pickup in Iowa for the seat held for almost 30 years by Democrat stalwart Tom Harkin and a victory in North Carolina, which reversed the perceived Democratic gains after President Obama carried the state in 2008.

Senate Committee Update

Finance Committee: With Republicans winning the majority, Senator Orrin Hatch (R-UT) will take over the reins as chairman of this committee. There were no other changes among current Republicans on the committee, and there has been no indication that Hatch’s committee staff will go through major revisions, although that is always a possibility. Senator Ron Wyden (D-OR) will become the ranking Democrat on the committee, and there has been no word yet about any major staff changes within his office.

Health, Education, Labor and Pensions (HELP) Committee: Senator Lamar Alexander (R-TN) will serve as chairman beginning in 2015. No Republican members are expected to leave the committee, although as with Finance, the ratio of Republicans to Democrats will probably flip. Senator Patty Murray (D-WA) will lead the minority as ranking member on the HELP Committee.

Gubernatorial Summary

November 4 was also a good night for Republicans at the state level, when the party secured a net gain of two governorships and currently controls the executive offices of 31 states to the Democrat’s 17. Notably, these gains included victories in traditional Democratic strongholds of Illinois, Maryland, and Massachusetts.

Outlook for the 2016 Presidential Election

Even as Republicans celebrated their hard-fought November victory, strategists within the party warned against complacency. After all, the party of the incumbent president typically suffers losses in the midterm congressional elections, and the peculiarities of House and Senate races don’t necessarily translate at the national level. Emerging demographic trends are projected to favor the Democrats, and factors such as the strengthening economy and falling oil prices (should they continue into 2016) could position the Democrats for a comeback.

Of course, much will depend on who each party nominates as their candidate for president. On the Republican side, Senators Rubio (FL), Paul (KY), and Cruz (TX) and Governor Christie (NJ) and ex-Governor Jeb Bush have all been mentioned as potential candidates. While the eyes and ears of the Democratic Party are focused on Hillary Clinton’s ambitions, Vice President Biden, former Senator Webb (VA), and incumbent Senator Sanders (VT) are all exploring the possibility of presidential bids.

Impact of Congressional Elections on ACCP’s Medicare Initiative

ACCP does not believe that the outcome of the November 2014 election will have a significant impact on the prospects for our Medicare Initiative. If anything, Republican control of the Senate could serve as the impetus needed to overcome the deadlock and impasse that plagued the 113th Congress. With one eye on the 2016 presidential election, the Republican Party―now in full control of the legislative branch―will be under increased pressure to use its majority to demonstrate the ability to govern effectively. House Republicans voted to repeal the Affordable Care Act (otherwise known as Obamacare) more than 50 times during the 113th Congress,¹ a purely symbolic measure that would never be adopted by the Democratic-controlled Senate or overcome a presidential veto. With majority status in the House and Senate comes the responsibility to produce a forward-thinking agenda to tackle the key issues facing our nation, rather than simply block Democratic initiatives. Optimistically, this could result in the emergence of bipartisan legislative initiatives that might include the policies outlined in ACCP’s Medicare Initiative.

ACCP’s Medicare Initiative is designed to position clinical pharmacists to participate as fully integrated members of the health care team in evolving care delivery and payment models. The process of care we propose is consistent with the vision for medication management in the Patient-Centered Medical Home (PCMH) endorsed by the Patient Centered Primary Care Collaborative (PCPCC) and is a component necessary to achieve many of the quality measures that Accountable Care Organizations (ACOs) are required to meet. We have made it clear that our proposal is not designed to encourage individual pharmacists practicing in silos to “hang out their shingle” and bill Part B.

Recognizing the difficult economic situation in the U.S. health care system and the challenges associated with enacting legislation that would ultimately add a new benefit to the Medicare program, we have gone to great lengths to position our initiative in a manner that appeals to both political parties. We have been successful in building a bipartisan working group of Senate offices that is developing a legislative strategy to advance this effort in the next Congress. Because of this bipartisan approach, we do not consider the outcome of the November election and the new majority in the Senate a significant factor.

Members of Congress from both sides of the aisle recognize that significant structural changes are needed to ensure Medicare’s long-term sustainability. For lawmakers primarily concerned about potential cuts in Medicare spending that would reduce benefits and limit options for seniors, we position our initiative as an opportunity to improve quality and outcomes for seniors while containing costs across the entire program. For lawmakers who prioritize deficit reduction and spending cuts, we present our initiative as an opportunity to modernize the Medicare program and integrate best practices from the private sector that will ultimately limit overall spending through reduced hospitalizations and other costly but often avoidable encounters.

Your Contribution to ACCP-PAC Can Help Advance Our Medicare Coverage Initiative

The political reality is that a legislative initiative cannot move forward purely on the strength of its own merits—grassroots advocacy and financial contributions are key to showing support for our initiative from elected officials’ own districts and states.

A well-funded Political Action Committee (PAC) will give ACCP the resources it needs to support our friends on Capitol Hill. ACCP-PAC is the only political action committee dedicated to electing members of Congress who are committed to advancing our Medicare Initiative. Contributions from ACCP-PAC to members of Congress will raise our profile on Capitol Hill, improve our standing among key lawmakers, and provide unique opportunities to discuss our initiative with potential congressional champions. Our PAC will also help ensure that elected officials who support our initiative remain in office to advance the goals of the proposal in the future. Only ACCP members are eligible to contribute to the PAC and allow us to make these vital political contributions. With more than 15,000 ACCP members, ACCP is in a position to become one of the most prominent pharmacy PACs in Washington. To do this, we need the widespread support of our membership.

If each ACCP member contributed just $25, ACCP-PAC would raise $350,000. All ACCP members should consider making a donation of at least $25 to ACCP-PAC. CLICK HERE to support your PAC today!

For more information on any of ACCP’s advocacy efforts, please contact:

John K. McGlew
Director, Government Affairs
American College of Clinical Pharmacy
1455 Pennsylvania Avenue NW
Suite 400
Washington, DC 20004-1017
Telephone: (202) 621-1820
E-mail: [email protected]

¹Washington Post. The House Has Voted 54 times in Four Years on Obamacare. Here’s the Full List. Accessed December 13, 2014. Available here.