A Powerful Massachusetts Delegation Bodes Well for Patients and Physicians

BY Alex Calcagno, Director, Advocacy, Government, and Community Relations

At noon on January 3, the 116th session of Congress was gaveled into session — the most diverse Congress in history and one determined to change the way Washington conducts business.

With 235 Democrats and 199 Republicans, the US House of Representatives was hit by a “blue tsunami,” and that wave is decidedly female. The freshman class of women is notable for the number of firsts: Representatives Alexandria Ocasio-Cortez and Abby Finkenauer, both 29 on election night, are the youngest women ever elected to Congress. Representatives Rashida Tlaib and Ilhan Omar are the first Muslim women to reach Congress, and Representatives Deb Haaland and Sharice Davids, the first Native American women. Representative Ayanna Pressley is the first African American woman to represent Massachusetts in Congress.

In the Senate, the number of women also broke records, with 15 women winning seats for a total of 25. Ten members of the freshman class of both chambers are members of the LGBTQ community. Additionally, a sizable number are mothers of young children. Both chambers are considering family-friendly changes — like rescheduling the time of votes to accommodate members with young children.

Top Priority for House: Health Care

One of the first actions of the new House was to pass a bill authorizing the filing of an appeal to the lawsuit, Texas vs. United States, in which a federal judge stayed the entire Affordable Care Act (ACA).

The Trump administration chose not to defend the law because it agreed in part with the plaintiff’s position — putting key patient protections such as coverage for pre-existing conditions, bans on lifetime caps, and mandated essential benefits at risk. The new House majority is determined to pass legislation that strengthens the ACA and expands its provisions.

Another issue high on the agenda of both parties and legislative chambers is controlling the cost of prescription drugs — although their solutions will vary dramatically. To date, Congressional proposals have ranged from increasing access to generics to capping out-of-pocket spending to allowing Medicare to negotiate prices to the government manufacturing drugs. The House is also expected to debate a Medicare for All or related proposals. Solutions floated in both chambers range from modest Medicare buy-ins for various populations to more comprehensive measures that would extend government-run health care to millions.

With majority rule, the Democrats also gain subpoena authority. The House is expected to examine conflicts of interest and other potential improprieties by the president, his family, and appointees.

Increased Reliance on Regulatory and Administrative Action

The longest government shutdown in history is over, but political observers wonder whether the prolonged paralysis will turn out to be a harbinger of the remainder of the session. The Trump administration is expected to increase its reliance on regulatory and administrative actions to implement the president’s agenda. Among the pending proposals:

• Changes to the “public charge rule,” which would deter families who are legally seeking entry into the US from obtaining legal health care
• Changes to the Title X family-planning program that would limit providers’ communications with patients and impede access to abortion services
• Changes to conscience clause rules, which would allow health providers to deny treatment to a patient based on “moral grounds”

The MMS opposed these rules and many others, deeming them harmful to patients and quality health care. There are concerns that the administration will also seek to block grant Medicaid through rulemaking — a proposal that has failed to be approved in every Congress and one that the MMS has consistently opposed.