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The 2014 elections are complete, and we now know the makeup of the next US Congress. Even though Republicans picked up more than the 6 seats needed to take control of the Senate, it may not mean that significant healthcare changes are imminent. As the congressional landscape transforms, legislators will have to address the following issues. The Affordable Care Act (ACA): There is little chance of seeing this act repealed or replaced with President Barack Obama still in office, as it is one of his most significant legislative achievements. He will not have an interest in repealing it, and the Senate does not have the two-thirds majority to overcome a presidential veto. We do know, however, that aspects of the law will be up for repeal or tweaking, including the medical device excise tax (2.3% of the sales price on certain medical devices); the employer mandate to offer qualified, affordable health coverage; and the 30-hours-per-week definition for a full-time employee. The bottom line is that even if Republicans control Congress, it is expected the ACA will remain largely intact. The real future of the ACA likely lies with the US Supreme Court. Earlier this year, conflicting rulings came from the Appeals Courts on the legality of the ability of federally run exchanges to offer premium assistance, as the law only allows subsidies for citizens signing up for insurance through state-based exchanges. The Supreme Court’s ruling that is expected in June 2015 could have enormous implications for the success of the law with the federal marketplace in 36 states. Another area that may see movement is the 21st Century Cures initiative: In 2014 the US House of Representatives Energy & Commerce Committee hosted hearings and roundtables to study issues that affect healthcare and innovation. In early 2015, the committee plans to introduce a bill that will address numerous issues, including one that touches on clinical trials.
Bipartisan-Supported Legislation The following issues largely have bipartisan support, so the makeup of Congress is not as important for these issues as are the methods decided upon to pay for them. Both houses of Congress have indicated they will prioritize legislation that has bipartisan support; the challenge will be finding ways to offset the cost.
A number of other issues may come up during the year, including oral parity and prompt pay discounts. These issues may be included in larger healthcare- related vehicles. The Association of Community Cancer Centers will host a Capitol Hill Day for its members on March 16, 2015. We encourage all of our members to attend this annual event and educate elected officials on these important issues.
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