By Howard Bedlin |
11.27.2018
The results of the 2018 midterm elections will have significant
implications on the nation’s public policy agenda—including issues affecting
older adults—over the next two years.
Changes in the House
Democrats could pick up as many as 40 new seats, establishing an
anticipated 234-201 margin in the House. That means, House Democrats can lose
only 16 votes within their party to pass legislation. So, the 20-25
conservative Democrats, also known as “Blue Dogs,” who could represent swing
votes, will likely have increased influence in the House.
It is not certain whether current Democratic Leader Nancy Pelosi
(D-CA) will be able to secure the votes needed to be the next House Speaker.
Several candidates who won office, as well as several current Democratic
members, have said they will not support her. The Democratic Caucus election is
Nov. 28, with a full floor vote Jan. 3, 2019. No one has formally announced an
opposition candidacy, so conventional wisdom is that Pelosi will become the
next Speaker, and some are speculating that an agreement will be reached for
her to serve no more than two years.
Other new leaders in the House will include chairs of important
committees that address senior issues.
- House Ways and Means Committee:
Richard Neal (D-MA) will chair this committee that has jurisdiction over
Medicare, Social Security, and tax issues. The chair of the Health
Subcommittee will be either Lloyd Doggett (D-TX) or Mike Thompson (D-CA).
- House Energy and Commerce
Committee: Frank Pallone (D-NJ)
will chair this committee that has jurisdiction over Medicare and Medicaid
issues. The Health Subcommittee chair will be Anna Eshoo (D-CA).
- Appropriations Committee:
The new chair will be Nita Lowey (D-NY), and the chair of the Labor,
Health and Human Services, and Education Subcommittee will be Rosa DeLauro
(D-CT).
- Education
and Labor Committee: Bobby Scott (D-VA) will
be the new chair of this committee, which will oversee the reauthorization
of the Older Americans Act (OAA)
in 2019.
Changes in the Senate
In the Senate, Republicans gained one seat for a margin of
52-48, and they may gain another, pending the outcome of the Mississippi runoff
race today. Mitch McConnell (R-KY) will continue to be the Senate Majority
Leader, with Chuck Schumer (D-NY) continues as Minority Leader. Moderate
Republicans such as Susan Collins (R-ME), Lisa Murkowski (R-AK), and Mitt
Romney (R-UT) are expected to be key swing votes.
One important leadership change is that Chuck Grassley (R-IA)
will take over as chair of the Senate Finance Committee which has jurisdiction
over Medicare, Medicaid, Social Security, and tax issues, replacing retiring
Orrin Hatch (R-UT). The Finance Committee.
The Policy Agenda
With the Democrats in control of the House, fears about key
programs being cut are eased. If Republicans had retained control of the House,
Senate, and White House, many expected they would continue to try to repeal the
Affordable Care Act (ACA) and significantly cut and cap Medicaid, which helps
about 7 million low-income seniors. There were also fears that Republicans
would attempt major cuts to Medicare, OAA and other discretionary
appropriations, and potentially Social Security to help pay for the $1.5
trillion increase in the deficit due to last year’s tax cuts.
Leaders, instead, are expected to focus on several key health
care issues, including reducing prescription drug costs, Medicare for All
proposals, and stabilizing the ACA. Other priorities will likely include
climate change, immigration, gun safety, voting rights, and infrastructure, as
well as several investigations of the White House.
Some of these bolder House issues have little or no chance of
passing the Republican Senate and being signed into law by the president.
However, some compromises can be made to gain bipartisan support and move
through to final passage.
NCOA Priorities
NCOA is focused on advocating for several issues of concern to
older adults:
- Program funding:
A two-year deal reached earlier this year raised budget caps and
maintained approximate parity between defense and non-defense
discretionary spending. A new deal will have to be negotiated next year,
and if no agreement is reached, sequestration will return for FY20 and
FY21. If that happens, non-defense discretionary programs (which includes
the OAA) will be cut by approximately $55 billion in FY20 alone.
- Social and Behavioral Determinants
of Health (SBDOH): NCOA is seeking to
improve access to SBDOH, including increasing funding for evidence-based
programs under the Prevention and Public Health Fund and improving access
to Medicaid Home and Community-Based Services (HCBS). We are working to
extend the Money Follows the Person (MFP) program and spousal
impoverishment protections, and to craft legislation to strengthen and
continue the ACA Balancing Incentives Payment (BIP) program. We are
hopeful that MFP will be extended for at least one year during the “lame
duck” session this December.
- Health care extenders:
Several important programs are due to expire Oct. 1, so some action on
Medicare and Medicaid is expected next fall. NCOA is particularly
concerned that authority for Medicare outreach and enrollment efforts is
among those that need to be extended. NCOA will be working to make the
funding permanent.
- Older Americans Act:
The OAA is due to be reauthorized in 2019. NCOA will seek to strengthen
the OAA, both through increased appropriations and reauthorization.
- House
Select Committee on Aging:
NCOA is advocating to reestablish this committee that was disbanded 25
years ago and the Leadership Council of Aging Organizations (LCAO)
supports this action. While the House committee would not have specific
authority over legislation like the current Senate Special Committee on
Aging, it could increase understanding and raise the visibility
of the challenges and opportunities presented by our aging nation and
promote well-informed improvements and solutions.
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