December has begun and we still don’t know who our next President will be. What were the odds that the November election results would still be up in the air at this point in December? Even more surprising, who would have predicted that control of the White House would ultimately be decided in a courtroom?
At least we can take solace in the certainty of the results of the Congressional elections. There is no mistaking the fact that a process of “centrification” took place at the polls. Voters split Congress down the middle on November 7. The Senate is currently evenly divided between Republicans and Democrats with 50 of each (if Gore were to finally win the presidency, a 51-49 split would likely occur with Lieberman’s ascendance to Vice-president). In the House, Republicans outnumber Democrats by a very narrow margin of 9 seats. Regardless of who wins the White House, Democrats and Republicans will be sharing power as never before in recent memory. “Centrification” insures that power will move more toward those members of Congress who are moderates and away from the extreme right and left. AAP has been working diligently over the past several years to cultivate close working relationships with moderate coalitions on both sides of the aisle.
Will the impact of this near equality be continued legislative gridlock, or a wave of something new and different in the form of greater bipartisanship? Only time will tell, but when the new House and Senate convene on January 3, neither party can claim they have a mandate. This will no doubt raise some very interesting problems for lawmakers who will face an array of fertile legislation left over from past party battles, including many bills that are popular with the public and some which even enjoy bipartisan support. Health care is at the top of the list of those bills commanding attention. The exit polls on November 7th confirm that the public is very concerned about the state of the health care delivery system. The question is, will this new split Congress be any more successful in pushing through meaningful laws than their predecessors who were more entrenched along party lines?
At the moment, members of Congress are distracted by the fight for the presidency. But, if we look ahead to the 107th Congress we see some huge legislative question marks involving psychologists which we hope will be answered by the 107th Congress. Among them is psychologists’ perennial favorite, the Patients’ Bill of Rights. Additionally, the Medicare prescription drug benefit and Medicare “givebacks” are equally tenuous and may be in danger of dying.
On the Patients’ Bill of Rights, participation and cooperation within the House and Senate conference appears to be dwindling, and passage appears doubtful this year. Some have suggested that should he become president, Texas Gov. George W. Bush could try to pass a bipartisan bill quickly to prove he can unite the parties. Bush, however, would have to win over fellow Republicans such as Senate Majority Whip Don Nickles and also sell Democrats on the legislation. Congressman Charles Norwood (R-GA), co-author of the Housepassed Norwood-Dingell Patients’ Bill of Rights, believes that a first order of business will be to figure out where there is consensus quickly. He has pointed to the fact that most major issues have a six-month shelf life, or they die a horrible death in gridlock. Norwood also thinks that under a Bush presidency, Democrats would be more likely to compromise on patients’ rights legislation because they would no longer have the backing of the president to argue for more concessions.
The Medicare prescription drug benefit remains the biggest and most unwieldy health issue of all. Sens. John Breaux (D-LA), Bill Frist (RTN), Olympia Snowe (R-ME and Ron Wyden (D-OR) will surely revive debate by resurrecting bipartisan bills they introduced earlier in 2000, yet any proposal will have to emerge from the strictly divided 107th Congress.
The “givebacks” measure – – which would restore roughly $30 billion in cuts to insurers and providers as part of 1997 Balanced Budget Agreement — had appeared to be a “must pass issue” for the 106th Congress. But now that members have been re-elected, will they continue to feel a need to pass such a measure? It is safe to assume that that there are only even odds that this will see the light of legislative day. Still, hospitals and providers have been steadily lobbying for passage, and some lobbyists believe the legislation will eventually pass out of fear that some hospitals and health care facilities will have to begin dropping services if they do not have funds for FY 2001.
On the whole, there is great potential for the split 107th Congress to exhibit real bipartisanship and a new ability to engage in constructive solutions to the serious problems in all sectors, but especially in the failing health care arena. Imagine what it would be like if the parties actually began to work together from day one to develop public policy positions that have the best of both sides and then attempted to sell that package to the largest number of members possible? That would be refreshing in my mind. It is very critical that we continue to keep the pressure on Congress so that they will help psychologists to deliver the mental health services that so many folks need today, more so now than ever before.