Webinar: EMR money might be safe in unpredictable post-election landscape
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The calls for repeal of the Patient Protection and Affordable Care Act (PPACA) have been loud, but there has been no corresponding anti-HITECH (Health Information Technology for Economic and Clinical Health) Act sentiment, said webinar keynote speaker Jennifer Haberkorn, a healthcare policy and political reporter at Politico, based in Washington, D.C. This might be due to a recognition that healthcare IT initiatives can save money, making other aspects of healthcare reform more inviting targets.
“The EMR money is unlikely to be touched. It’s already moving through the regulatory process and so much else going on in the healthcare space, the people I’ve talked to say it’s not really on the radar as some of the other money in the healthcare reform law might be, such as the preventive care fund," said Haberkorn.
“A full repeal of the healthcare reform law would likely pass the House and die in the Senate,” Haberkorn predicted, because Democrats still control the Senate and the President has veto power. However, chipping away at smaller pieces, such as the individual mandate and taxes on medical devices, might be a more effective strategy. “It’s kind of an open game right now. Expect Republicans to throw a lot of things against the wall and see what sticks.”
Any HITECH funding that hasn’t been appropriated yet could be cut back, but it might not be on the radar at this point. "Right now, the attitude on the Hill is that this money is going toward creating jobs, where some of the money isn't,” she said.
While many people focused on the national level, there were many races at the state level that could have implications on health IT policy, according to Tim Storey, senior legislative fellow with the National Conference of State Legislatures.
“It was a dramatic change election for state government across the U.S.,” Storey said. Eighty-five percent of all state legislative seats were in play in 2010 and 20 legislative chambers changed hands. There also are 28 new governors, the highest number in history. “That’s a large number of new leaders leading new governments into what is still a fiscally challenging environment,” said Storey.
Therefore, health IT professionals working with states should expect a much more fiscally conservative approach in terms of governance, he said.
“Revenue projections are showing some glimmer of recovery, but stimulus money is running out at the same time. Whatever revenue increases we’re seeing are going to largely be for backfill for losing stimulus,” and there is going to be pushback on the healthcare reform law, said Storey. “Everything is going to be cast through the fiscal prism” with states facing “very hard choices about what they can fund.”
New governors will also influence implementation of healthcare reform and HITECH, said Kathleen Nolan, MPH, director of the Health Division at the National Governors Association.
“Regardless of party change, a new governor comes in with a new team. Sometimes, the new team goes deeper into agency level, so you will see new commissioners of health, new Medicaid directors, new insurance commissioners and many other new people who will take up the new mantle of leadership around state healthcare,” Nolan said.
However, a lot of things haven’t changed: “Budget issues are going to dominate as they did prior to the election,” she said. “The first thing they are going to have to deal with is their Medicaid budget for next year, [and] the Medicaid-enhanced match is going away. This is going to be an incredibly difficult time fiscally, and is going to play out in a lot of different issues in healthcare.
“The other thing to remember, purely from operational standpoint, is regardless of what state you’re working in, state staff is incredibly stretched. The people you work with and talk to in governors' offices and executive branches are going to be under incredible duress in every state,” said Nolan.
“As new governors move from campaign mode to governing mode, they’re going to have to get their arms around what their potential directions are, what their existing obligations and initiatives that are in the state [are], what do those mean and do they want to continue them,” she said. “It’s important for anybody working with state government to really get to know the priorities of the incoming leadership, both on the legislative and gubernatorial side.”