By John Coster, RPh., Ph.D.
Yesterday’s election has not resulted in significant political change because voters have essentially endorsed the status quo in a time of widespread unhappiness about the economy and other matters. As a result, the country will continue to have a divided government with a Democrat White House, a Democrat majority in the Senate, a Republican majority in the House of Representatives and a Republican majority of Governorships.
Presidential: After a year of intense campaigning and record spending by candidates, parties and outside groups, President Barack Obama (D) has won a second term. The President was successful in winning the key swing states of Colorado , Iowa, Nevada, New Hampshire, Ohio, Virginia and Wisconsin to top Republican candidate Mitt Romney, with at least 303 electoral votes (with Florida yet to be called). He will be inaugurated for a second term on January 20th, 2013.
Key issues for health care providers will include whether Kathleen Sebelius remains Secretary of Health and Human Services (HHS) in a second term, and how the Administration will implement key provisions of the Affordable Care Act, including state health care exchanges which have to be up and running by October. We also expect there to be major entitlement reform changes in the next Congress—including changes to Medicare and Medicaid—as part of a deficit reduction deal.
U.S. Senate: Democrats will retain control of the Senate after winning several closely contested races. Democrats picked up two Republican seats with Elizabeth Warren defeating incumbent Republican Sen. Scott Brown in Massachusetts and Democratic Rep. Joe Donnelly scored an upset in the Indiana Senate race when he won against tea party candidate Richard Mourdock. Democrats also scored notable victories in Virginia, Ohio and Connecticut.
As it looks right now the new Senate line-up will be comprised of 54 Democrats (includes 2 Independents expected to caucus with Democrats) and 45 Republicans (with North Dakota yet to be called at this point). Senate Pharmacy Caucus Chair Jon Tester was reelected. In the next Congress, Senator Max Baucus (D-MT) will remain Chairman of the Senate Finance Committee and Senator Orrin Hatch (R-UT) will be the Ranking Republican. Senator Tom Harkin (D-IA) will remain Chairman of the Senate HELP Committee (with jurisdiction over the FDA, including pharmacy supply chain security and compounding) and it is expected that Senator Lamar Alexander (R-TN) will become Ranking Republican.
U.S. House of Representatives: Republicans kept a lock on the U.S. House of Representatives, a crucial victory after the party failed to wrestle away the presidency from Barack Obama and the Senate from the Democrats. The GOP led 231 to 191 while votes were being tallied early Wednesday. The Republicans controlled the House by 242-193 going into the election where all 435 seats were up for grabs.
While the GOP will retain a strong majority with at least 231 seats, there will be historic generational turnover. More than 4/5 of the 87 member GOP freshman class of 2011 won a second term and the next freshman class will include at least 80 members. Which means that more than a third of members will have less than three years of House experience when the next Congress is sworn in in January.
We are also headed for the most polarized House in history—Democrats in the Blue Dog Coalition have been cut in half for the second consecutive cycle, while the ranks of Tea Party hardliners in the House GOP have grown modestly. With Democrats gaining seats in California and Illinois but losing more seats across the rural South, this is the first time in history women and minorities will be a majority of the Democratic caucus.
With respect to health care issues, Rep. Dave Camp (R-MI) will remain Chairman of the Ways and Means Committee, while Rep. Sander Levin (D-MI) remains the Ranking Democrat. On the Energy and Commerce Committee, Rep. Fred Upton (R-MI) remains Chairman, while Rep. Henry Waxman (D-CA) remains the Ranking Democrat. Long time Rep. Pete Stark (D-CA), one time Chairman and now Ranking Member of the Ways and Means Health Subcommittee lost his reelection. Health care leaders Reps. Cathy McMorris Rodgers (R-WA), Aaron Schock (R-IL), Peter Welch (D-VT), JoAnn Emerson (R-MO), and Austin Scott (R-GA) all won reelection.
Governors: There were only 11 Governors races this cycle, with Democrats defending eight and just three for the Republicans. Republicans were able to pick up at least one Governorship in North Carolina (with Washington yet to be called), which has resulted in Republicans holding at least 30 Governorships, Democrats 17 and 1 Independent (Rhode Island) overall.
As we begin to work with many newly elected officials, we will continue in our efforts to address a number of challenging issues for independent community pharmacies and their patients. Our focus, and our efforts, has not changed with Tuesday’s election. We will continue to confront growing federal budget deficits, additional pressure to reduce federal spending, and an active and aggressive regulatory and rule making environment. Our job going forward is to ensure that NCPA is well positioned to advocate on behalf of independent community pharmacists and the patients that they serve.