Donald J. Trump’s triumph in the 2016 presidential election stunned the Washington establishment. Going into election day, extensive polling data and supposedly sophisticated statistical modeling overwhelmingly indicated that Democratic candidate Hillary Clinton would prevail. Political strategists were focused on the traditional battleground states of Ohio and Florida, and few considered that Democratic strongholds like Wisconsin and Michigan might be in play.

But as election night unfolded, Trump swept the battlegrounds of Florida, Ohio, North Carolina, and Pennsylvania while scoring unexpected victories in Michigan and Wisconsin. In the end, despite losing the popular vote by a margin of 2.5 million,¹ Trump dominated the Electoral College count at 306-232 and, in doing so, secured the presidency in the most unlikely circumstances.

It wasn’t just Democrats who were reeling from the November 8 result. Trump’s victory left many in his own party scrambling after they had distanced themselves from the president-elect during his unconventional and controversial campaign. Shockwaves were even felt within Trump’s own camp when key figures from his campaign were ousted as the transition process began in earnest.

Yet beyond the uproar, Clinton’s measured but respectful concession speech and a reportedly cordial meeting at the White House between the president-elect and outgoing president Barack Obama appear to have smoothed the route toward the inauguration on January 19 and the beginning of the Trump era for the nation.

Transition Process to Date

Despite vocal campaign promises that he would “drain the swamp,” Trump has so far nominated several familiar Washington leaders for Cabinet positions:

• Attorney General: Sen. Jeff Sessions (R-AL). Chair of the Senate Subcommittee on Immigration. First member of the Senate to endorse Trump.
• Secretary of Defense: Retired Gen. James Mattis. Former commander of U.S. Central Command. Led a Marine division into Baghdad during the 2003 invasion of Iraq.
• Secretary of Health and Human Services: Rep. Tom Price (R-GA). Six-term congressman and orthopedic surgeon. Vocal critic of Obamacare.
• Secretary of Housing and Urban Development: Ben Carson. Former director of pediatric neurosurgery at Johns Hopkins Children’s Center and former candidate for Republican presidential nomination.
• Secretary of the Department of Education: Betsy DeVos. Billionaire philanthropist. Head of the American Federation for Children.
• U.S. Ambassador to the United Nations: Gov. Nikki Haley (R-SC). Served three terms in the South Carolina State House before being elected governor in 2010.
• Secretary of Transportation: Elaine Chao. Former Labor Secretary under George W. Bush. Married to Senate Majority Leader Mitch McConnell.
• Secretary of the Treasury: Steve Mnuchin. Served as the Trump campaign’s National Finance Chair. Former partner with Goldman Sachs.
• Secretary of Commerce: Wilbur Ross. Billionaire businessman who made his fortune by buying up and restructuring companies in industries such as steel and coal.
• Secretary of Homeland Security: Retired Marine Gen. John F. Kelly. Former chief of U.S. Southern Command. Served as the assistant commander of the 1st Marine Division under Gen. Mattis during the 2003 invasion of Iraq.

ACCP recently wrote to Trump to congratulate him on his victory and to introduce the transition team to the College and ACCP’s efforts to integrate comprehensive medication management (CMM) into evolving delivery system and payment reform efforts. Click here to read the letter in full.

Looking Toward the 115th Congress

The lame-duck session of the 114th Congress that met after the November election approved a continuing resolution that would fund the government through April 28, 2017, and give the next Congress time to address the annual appropriations process.

The 115th Congress will be sworn in on January 3, 2017. In the House, despite a net loss of six seats, the Republicans remain in the majority with 239 seats to the Democrats’ 194 (two House seats remain undecided). The picture is similar on the Senate side, where, despite a net loss of two seats, the Republican Party narrowly retained its majority with 52 seats to the Democrats’ 48 (including two independent senators who caucus with the Democratic Party).

Senate Majority Leader Mitch McConnell (R-KY) indicated that an effort to allow for the replacement of the Affordable Care Act (ACA—also known as Obamacare) would be the first item of business for the Senate using a bare-bones fiscal 2017 budget resolution that would include instructions for partial repeal through the budget process known as reconciliation.

Incoming Minority Leader Chuck Schumer (D-NY) responded bullishly that his party would block any attempt to roll back Obama’s landmark legislative achievement. However, without the threat of a presidential veto, the options for the minority party are limited because the budget reconciliation process is not subject to filibuster rules.

ACCP believes that the prospect of a major health care legislative shakeup could provide an opportunity to advance its Medicare Initiative to establish coverage for CMM services delivered by qualified clinical pharmacists. However, little is known about what congressional Republicans and leaders in the White House and Trump administration have planned for a replacement for the health care law they have vocally vilified since its passage in 2010.

Anticipating significant legislative action on health care issues, ACCP hopes to continue its bipartisan work with Representatives Paulsen (R-MN) and Welch (D-VT) on improving care delivery and outcomes for Medicare beneficiaries with chronic conditions.

115th Congress Leadership

The future of the ACA remains subject to speculation, but one of the tasks undertaken during the lame-duck session was to confirm leadership assignments for the 115th Congress. The highlights are listed below:

Senate Majority Leadership

Majority Leader: Mitch McConnell (R-KY)

Assistant Majority Leader (Majority Whip): John Cornyn (R-TX)

Senate Minority Leadership

Minority Leader: Charles Schumer (D-NY)

Minority Whip: Dick Durbin (D-IL)

Assistant Minority Leader: Patty Murray (D-WA)

Senate Committees

Finance Chair: Orin Hatch (R-UT) (subject to confirmation)

Finance Ranking Member: Ron Wyden (D-OR)

HELP Chair: Lamar Alexander (R-TN) (subject to confirmation)

HELP Ranking Member: Patty Murray (D-WA)

House Majority Leadership

Speaker of the House: Paul Ryan (R-WI)

Majority Leader: Kevin McCarthy (R-CA)

Majority Whip: Steve Scalise (R-LA)

Conference Chair: Cathy McMorris Rodgers (R-WA)

NRCC Chair: Steve Stivers (R-OH)

House Minority Leadership

Minority Leader: Nancy Pelosi (D-CA)

Minority Whip: Steny H. Hoyer (D-MD)

Assistant to the Leader: James E. Clyburn (D-SC)

Caucus Chair: Joseph Crowley (D-NY)

Caucus Vice Chair: Linda T. Sánchez (D-CA)

House Committees

Energy & Commerce Chair: Greg Walden (R-OR)

Energy & Commerce Ranking Member: Frank Pallone (D-NJ)

Ways & Means Chair: Kevin Brady (R-TX)

Ways & Means Ranking Member: Richard Neal (D-MA) (subject to confirmation)

Congress Approves 21st Century Cures Bill

In one of the final acts of the 114th Congress, the Senate approved H.R. 34, the 21st Century Cures Act, by a margin of 94-5. Obama signed the bill into law on December 13. This complex piece of legislation is intended to expedite the discovery, development, and delivery of new treatments and cures and maintain America’s global status as the leader in biomedical innovation. The bill will boost funding for medical research, ease the development and approval of experimental treatments, and reform federal policy on mental health care.

Specifically, the legislation includes:

• $4.8 billion in new funding for the National Institutes of Health (including $1.8 billion reserved for the “cancer moonshot” launched by Vice President Joe Biden to accelerate research in that field after his son Beau died of cancer in 2015).
• $1.6 billion earmarked to fight brain diseases, including Alzheimer disease.
• $500 million in new funding for the U.S. Food and Drug Administration.
• $1 billion in grants to help states deal with opioid abuse.

The bill also served as a vehicle for H.R. 2646, the Helping Families in Mental Health Crisis Act, aimed at ensuring science-driven and evidence-based approaches to care of individuals with mental illness and/or substance use disorders and working to address the critical shortages of psychiatrists and other mental health practitioners.

However, despite overwhelming bipartisan support, the bill came under fire from the left-leaning progressives, including senators Bernie Sanders (I-VT) and Elizabeth Warren (D-MA), who voiced concern that changes to the FDA would result in products approved on the basis of evidence collected from sources other than randomized clinical trials, such as patient data collected from medical records or insurance claims.

Click here for a comprehensive summary of the 21st Century Cures Act.

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
(202) 621-1820
[email protected]

¹NBC News Article: Democrats’ Popular Vote Advantage Is Growing But That May Not Equal Election Wins. Available here. Accessed December 7, 2016.