1.24.2019
Leslie Krigstein – VP, Congressional Affairs

The November election results sparked questions about the future of health IT-related policy. New House leadership combined with the influx of new (mostly Democratic) members in the House and the loss of some familiar faces in the Senate suggest change is afoot. With committee assignments now in place, we have a clearer idea of what might be in store in 2019.

Committee rosters in the House and Senate look quite different as incumbent loses and retirements impacted committees with healthcare jurisdiction. Health IT has largely been a topic garnering bipartisan interest on Capitol Hill; however, new committee leadership and a change in who holds the gavel will likely impact the lens through which issues are examined.

The Senate remains in the hands of a Republican majority, with some committee ratios shifting slightly to reflect the larger Republican majority. The leadership of the Senate Health, Education, Labor and Pensions Committee will remain unchanged, as Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) will continue oversight of health IT, electronic health records and the implementation of the 21^st Century Cures Act. Alexander’s retirement in 2020 may factor into what issues he steers the committee toward, knowing that healthcare cost is one of his priorities.

There was a shakeup on the Senate Finance Committee, which has Medicare and Medicaid under its jurisdiction, with the retirement of former Chairman Orrin Hatch (R-UT) and the losses of incumbent members Bill Nelson (D-FL), Claire McCaskill (D-MO) and Dean Heller (R-NV). Sen. Chuck Grassley (R-IA), a fierce oversight and transparency advocate, left the helm of the Senate Judiciary Committee and took over as Finance Committee chair in January.

In January, the House became controlled by the Democrats, who gained more than 30 seats. This correlates to many new members and many new faces on committees of jurisdiction. The Energy and Commerce Committee gavel is in the hands of the current ranking member, Frank Pallone (D-NJ), who l swapped places with Greg Walden (R-OR). The Health subcommittee got new leadership with the retirement of Gene Green (R-TX), with Anna Eshoo (D-CA) taking his spot.

The House Ways and Means Committee also saw a change with the loss of health subcommittee chairman Peter Roskam (R-IL) along with eight Republican committee members who did not seek re-election, and the retirement of Sander Levin (D-MI). Lloyd Doggett (D-TX) is now the health subcommittee chair.

We expect consumer and patient privacy to take center stage, with interest expressed by leaders of the Energy and Commerce Committee and Senate Commerce Committee. The lines between health data and consumer data are blurring with the growing popularity of wearables and apps to download records, raising concerns that these valuable data streams may teeter outside of the reach of the Health Insurance Portability and Access Act (HIPAA). If and how the committees will address this in 2019 is unclear.

The past Congress attempted to delve into the implementation of the 21^st Century Cures Act, but much of the rulemaking has been stalled at Office of Management and Budget and the ongoing budget shutdown. Health IT has been bipartisan, so the forecast should show continued conversation about how to spur interoperability, improve patient access and reduce provider burden. Additionally, with the potential consideration of an infrastructure package, there could be an opportunity for health IT and cybersecurity readiness to be interjected into the conversation. The Office of the National Coordinator for Health IT’s apparent perennial fight for funding will likely factor into their ability to go beyond what is mandated in statute.

We see possible headwinds and unknowns as well. A court ruling on the Affordable Care Act will likely serve as a distraction, for both parties, as health agendas are formulated in 2019. And the influx of diversity among recently elected candidates, with unprecedented numbers of women, minority and millennials, is a wild card.

We can only wait and see how these factors play out as the year progresses. Be sure to join us June 26-28 in Washington, D.C., for our second annual CHIME Advocacy Summit. Our speakers will give an in-depth and up-to-date look at policy developments. The summit also will include opportunities to network with D.C.’s top decision makers and more. For information and to register, go here.

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