What Could the Upcoming Midterm Elections Mean for Physicians and Healthcare?

Leigh Page


October 09, 2018

In This Article

A Divided Congress Would Bog Down Healthcare Legislation

Could this election produce a different kind of officeholder who sneers at compromise to get things done? One outcome of Trump victory in the 2016 presidential election, Pearl believes, is that candidates in both parties are more comfortable with extreme rhetoric.

The old logic was that extreme positions couldn't win general elections. The new logic is that only candidates with strong, even radical, ideas can win over the voters.

"The old logic was that extreme positions couldn't win general elections," he says. "The new logic is that only candidates with strong, even radical, ideas can win over the voters."

The prospect of a Congress packed with politicians who resist compromise comes at a time when compromise might become all the more necessary. A Democratic House would put the brakes on the Trump agenda and make horse-trading essential to get anything done.

"It would be doubtful that much, if any, of the Trump healthcare agenda would get through," predicts Joshua Cooper, senior director of Congressional relations for the American College of Radiology.

What Are the Possibilities?

If Democrats won the House, they would suddenly have a lot of power. They would run the committees that send bills to the House floor, initiate public hearings, and summon administration officials to testify through the power of the subpoena.

Even if Democrats didn't win absolute control of the House, and just won a lot more seats, they would gain greater representation on the committees, says Ted Burnes, director of the Radiology Political Action Committee, which donates to campaigns on behalf of radiologists.

The math is simple: The more seats a party holds, the more members it gets on the committees. "In this hyperpartisan climate, committee ratios are a very critical part of the process," Burnes says. With just a one-member majority on committees, the outcome could shift entirely if just one or two committee members defected from the majority party.

A Democrat-run House would know that any legislation it passed would be quickly overruled by a GOP-run Senate and President Trump. But Democrats might still be able to get parts of their agenda through by attaching measures to must-pass legislation, such as spending bills. That's when the horse-trading would begin, and Democrats might score some points.

Total gridlock wouldn't sit well with many voters who prefer both parties working together. When it comes to what the voters want, Democratic politicians are actually under more pressure to compromise than are their Republican counterparts.

A 2017 Gallup poll showed that 62% of Democrats favored compromise in Washington, compared with 44% of Republicans. And those who described themselves as "very conservative" were least likely to object to gridlock. Only 29% of them favored compromise, compared with 55% of those who described themselves as "very liberal."[6]


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