In today’s webinar “Understanding the New Congress,” AHIMA’s federal affairs staff outlined AHIMA’s legislative and regulatory priorities for the 116th Congress. Lauren Riplinger, JD, AHIMA’s senior director of federal relations, discussed what will and what will not change in light of demographic shifts in House and Senate leadership, as well as the implications of working with a divided government since Democrats took control of the House. This webinar also covered topics related to what is currently the third-longest government shutdown in Congressional history and its implications for health information management (HIM) professionals.
The Government Shutdown
Fortunately for HIM professionals, the government agency with the greatest impact on the industry, the Department of Health and Human Services (HHS), is largely unaffected by the current government shutdown because it is funded by a spending bill passed earlier in 2018. As such, HHS’s Office for Civil Rights (OCR), the Office of the National Coordinator for Health IT (ONC), and the Centers for Medicare and Medicaid Services (CMS), are largely functioning as they normally would.
However, the HIM and health IT industries are anxious to see ONC’s long-awaited proposed information blocking regulation which was mandated by the 21st Century Cures Act in 2016. Stakeholders are eager to see the rule since it is expected to have an impact on the interoperability of electronic health records (EHRs). AHIMA commented on the proposed rule back in October. According to Riplinger, ONC sent the proposed rule to the Office of Management and Budget (OMB) before the shutdown. All proposed regulations must be cleared by OMB before they are made public, but OMB operations have been stalled by the shutdown, so the timetable for release is difficult to predict at this time.
Riplinger is fairly confident that the shutdown will not impact AHIMA’s Advocacy Day event on Capitol Hill, in part because the salaries of legislative staffers in the House and Senate are funded during the shutdown, so AHIMA members will be able to meet with them. In addition, because AHIMA has hosted advocacy events for so many years, members of Congress are familiar with AHIMA members.
Working with the New Congress
The 2018 midterm elections resulted in Democrats gaining 40 seats in the House of Representatives, giving them control of the chamber. To regain the majority, they only needed 23 new seats. This shift in control means that Democrats will now lead the committees that have the most jurisdiction and oversight of interests related to healthcare and HIM. On the House side, that means the Appropriations, Education & Labor, Energy & Commerce, and Ways & Means committees.
Additionally, the high turnover rate means that one-quarter of the House are new and have yet to meet with officials from AHIMA. So Riplinger and other AHIMA policy staff will be busy introducing HIM issues to the new “freshman class” of House members.
AHIMA keeps close tabs on these committees. “Leadership changes can signal a priority change, and a change in leadership at committee level can shift dynamics and focus. Legislation that was once languishing in committee could see some activity because a new ranking member may prioritize it,” Riplinger said.
For AHIMA members interested in advocating for AHIMA’s key legislative priorities, such as patient identity and safety, interoperability, and HIPAA protections for patients’ substance abuse information, Riplinger recommends reaching out to the ranking members of these committees—particularly if you are from their congressional district.
Less has changed on the Senate side, where Republicans maintained their majority and their leadership in key committees. The most important Senate committees for HIM issues continues to be the Appropriations; Commerce, Science & Transportation; Finance; and Health, Education, Labor and Pensions (HELP) committees. The only change is that the chairman of the HELP committee, Lamar Alexander (R-TN), has announced he will not run for re-election in 2020.
Getting bills and legislation passed when one party controls the House and one party controls the Senate can be much more difficult, and Riplinger anticipates that this may mean that President Trump may try to pursue his legislative agenda through the issuance of executive orders. Democrats are expected to focus on oversight and investigations on issues such as healthcare, foreign policy, and national and election security.
Legislatively, Riplinger expects to see legislation around stabilizing the Affordable Care Act (ACA) and protecting individuals with pre-existing conditions—particularly in light of a federal court in Texas that struck down the ACA in December. We may also see drug pricing as a priority, including how to introduce transparency into manufacturing pricing systems.
“It is possible the Senate will move on consumer privacy legislation. It’s a bipartisan interest in light of the recent Facebook news and hearings. Parties will diverge on what standards and enforcement look like. Our concern is the extent to which healthcare is related to consumer privacy law. We’ll keep a close eye on those discussions as they move forward,” Riplinger said.