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Friday, October 31, 2014

November 4th day of reckoning: what happens to Health IT should the GOP regain full control of the Congress?


Any thoughts? While it's a safe bet that we'll see multiple renewed bills passed in both the House and the Senate to "repeal ObamaCare," Republicans will still not be able to muster veto-proof margins, so that effort will simply continue to be the maudlin circus with which we are by now quite familiar.*
* SCOTUS could still effectively scuttle the PPACA by striking down the federal HIX subsidies in the states that refused to play ball and establish exchanges. There's a case in play right now (King v. Burwell). 11/3 UPDATE: the Supreme Court has declined to hear it -- for now.
We're also perhaps likely to see an Impeachment resolution accepted by the Senate for "trial." But, again, there will not be even close to sufficient votes to convict. Simply more narcissistic dog and pony show on this count. In that vein, there will be new GOP Senate committee chairs exercising subpoena power for all manner of political fishing expeditions. We can also expect a halt to federal judicial nomination confirmation hearings, given that the Republicans will control the Senate proceedings calendar.

Beyond the Clown Car stuff will be all manner of serious, pressing national and global issues to be dealt with, all vying for attention and resources: ISIL, Iranian nukes, Russia, climate change, immigration policy, financial regulation reform, etc, just to cite a few above-the-fold topics.

One consequence is that health IT looks to me like it's entering an even more pronounced  period of "benign neglect" at the federal level. ONC is out of effective leadership (leaders with sufficient visible national Cred to have Juice on the Hill), out of money, and still slavishly committed to their Quixotic "non-regulatory, market-based incentives" approach to interoperability. Stage 2 Meaningful Use is not gettin' any love from providers (increasingly dubious now that Stage 3 will even get out of the gate), and CCHIT has tossed in their CHPL Certification towel (see my prior post).

Moreover, -- beyond the foregoing carnival items -- all eyes will be firmly focused on the 2016 Presidential and downrace efforts (already well underway, to be sure). Hard to see how any new federal health IT initiatives will get much congressional attention or traction (and funding). Maybe market forces will continue to rule, in random walk fashion -- albeit shaped to a degree by statutes and regs already in place, increasingly vestigial as they may be.

Dunno.

IN OTHER NEWS


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More to come...

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