Regardless of your partisan leanings, you had to be surprised by the strength of the state and federal Republican landslide in last week’s elections. (In case you somehow missed it, the GOP swept all the Texas statewide contests, won control of the U.S. House of Representatives, narrowed its minority margin in the U.S. Senate, took a nearly 2-1 advantage in the Texas House, and kept its 19-12 superiority in the Texas Senate. Gov. Rick Perry’s reelection effort led the Republican tide in Texas. The GOP won 21 new seats in the Texas House and three Democratic seats in the Texas delegation to Congress.) The victors’ campaign messages consistently featured tough anti-Washington rhetoric and fiscal conservatism. What do the election results portend for medicine when the Congress and Texas Legislature convene for new sessions in January?
In Washington, the new Republican House majority probably can’t overcome the Democratic leadership in the Senate and President Obama’s veto pen to actually repeal and replace the health system reform law. Expect them to hold a largely ceremonial vote on such a plan but then use the power of the purse to starve implementation of many of the new law’s programs.
We’re still pushing for the lame duck congressional session to vote for a 13-month reprieve of the pending 30-percent Medicare payment cuts for physicians. With the Democratic leadership reeling, there’s no telling what will happen in the lame duck. And if they slap on another patch — or worse, do nothing — will the 2011 House leadership support Medicare payment reform?
The Texas Legislature will convene next year facing a record $20-billion-plus shortfall. With that big a hole, look for health, human services, and education programs to be on the chopping block. Some GOP leaders are even floating the idea of Texas opting out of Medicaid.