Last night, the American people made their voices heard in an unpredictable election. As happens prior to any election cycle, AcademyHealth has been thinking about how each election outcome could shape the future of our organization and the field of health services research. Now that the results are in, we can put ideas into action and take the steps necessary to move us forward.
The changes in the makeup of the White House, the House of Representatives, and the Senate provide us with an opportunity to pause, to examine where we are and where we go from here.
Like so many others, AcademyHealth has been monitoring this election and the information that has been released prior to and since the results were announced. And while we now know the election’s outcome, there is still much we don’t know.
At this point, there are already rumors about the Cabinet and the White House swirling, including the potential nominees for the Secretary of the Department of Health and Human Services (HHS). These names include Florida Governor Rick Scott, former House Speaker Newt Gingrich, and former presidential candidate Dr. Ben Carson. (Read more from Politico here and here.)
AcademyHealth is also closely monitoring several other priority areas of our members. Below, we have outlined a few key pieces we’re watching, followed by a brief description containing our understanding of where things presently stand:
Funding for the Agency for Healthcare Research and Quality
As we’ve updated you on before, for the past several years, the Agency for Healthcare Research and Quality (AHRQ) has struggled to receive funding in the House Appropriations Committee’s spending bills.
Fortunately, as evidenced through the agency’s proposed funding level in fiscal year 2017 and in ‘Dear Colleague’ letters recently circulated by policymakers (here and here), we believe that lawmakers are increasingly seeing the value of AHRQ and its continued contributions not only to patient safety but also to improving the effectiveness and efficiency of the U.S. health care system. We consider that a success of collective efforts under our #SaveAHRQ campaign last year.
With these achievements in mind, we are optimistic that AHRQ is not under any immediate threat. In the near term, that’s due at least in part to the fact that Congress and the administration are more likely to focus their initial efforts on repealing the Affordable Care Act (more on that below). In the meantime, AcademyHealth will continue working with members of Congress and their staff to raise the visibility and promote the value of AHRQ and its life-saving health services research.
The Fate of the Affordable Care Act
The Trump administration and Republican lawmakers are on record as saying that repealing and replacing the Affordable Care Act (ACA) is at the top of their “wish list.” Woven into this health care law are the Patient-Centered Outcomes Research Institute (PCORI) and the Center for Medicare and Medicaid Innovation (CMMI), whose fates are largely tied to the ACA. However, this isn’t a sure thing.
While Republicans could repeal many elements of the Affordable Care Act with a simple majority vote through the budget reconciliation process, PCORI and CMMI may fly under the radar; previously, the Republican Congress passed a reconciliation package repealing the ACA (the bill was vetoed by President Obama) that did not include provisions related to PCORI or CMMI.
Additionally, while all bets are off with the ACA, last year we saw the Medicare Access and CHIP Reauthorization Act (MACRA) pass with bipartisan support. This legislation represented a significant step in the move from volume to value, and that transition will require health services research to understand the impact of changes in payments and other incentives.
Effects on the National Institutes of Health
The National Institutes of Health (NIH), the largest funder of health services research, has and will continue to see strong bipartisan support in Congress; we expect this to continue. While President-elect Trump has previously said, “I hear so much about the NIH, and it’s terrible” (article here), we are hopeful that Congress is likely to ensure the agency’s future in the Trump administration.
Regardless of what lies ahead, AcademyHealth will continue seeking each and every opportunity to promote the value of health services research to lawmakers, both longstanding and new members of Congress, as well as the individuals who will lead in the Trump administration.
Importantly, as we’ve seen time and again, we make the strongest impact when we come together. We need our community to speak out; we need our champions to advocate for health services research and its role in a new administration; and we need you, as members, supporting us. After all, your dues allow us to act as your voice in Washington.
This election has been referred to as the most divisive in U.S. history, so we understand many of you may be feeling a range of emotions. But know that however you feel, together, we can continue to advance our collective mission – supporting the production and use of rigorous evidence to improve health and the performance of the health care system.
If you have any questions, please contact us.