Election 2018 - Outlook for the 116th Congress

Legislation | November 06, 2018 | by Barbara Gay

The 2018 mid-term congressional elections hold the potential for significant change in the next Congress. For either party, taking or maintaining control of one or both houses is going to mean confrontation with cold realities after the heady season of making campaign promises.

A change in the party controlling one or both houses would mean new leadership and committee chairs with new priorities for legislative activity over the next two years.

Before the new Congress begins, the current Congress will meet in a lame duck session. If Democrats gain a majority in either house for the next Congress, they may want to put the brakes on lame duck legislative activity so as to be able to legislate issues reflecting their priorities in the new Congress. On the other hand, in that situation Republicans would be anxious to get as much done as possible while still controlling both houses in the lame duck session.

The primary task in the lame duck session will be for Congress to complete work on fiscal 2019 appropriations. The measure covering home- and community-based services under the Older Americans Act has been enacted, but senior housing appropriations are under a continuing resolution that expires December 7. We are working for the maximum possible levels of funding for affordable housing for older people and are urging Congress to finalize fiscal 2019 funding so as to prevent payment problems that tend to occur when programs are subjected to a string of continuing resolutions.

We also are urging the current Congress to finish work on reauthorization of the Money Follows the Person demonstration program under H.R. 5306 and S. 2227, the EMPOWER Care Act.

If Republicans continue to control both houses in the new Congress, they may once again try to repeal the Affordable Care Act (ACA). However, in the year since their last attempt, it has become apparent that the ACA has gained in popularity, especially the law’s protections for people with preexisting conditions.

Republican candidates have promised to continue those protections. However, the ACA financed coverage for people with high health care costs through the mandate that everyone pay into the health care system. The individual mandate now has been repealed but without anything to replace it, and there is still no comprehensive proposal for replacing the ACA as a whole.

The current Senate Majority Leader, Senator Mitch McConnell, has said that mandatory spending programs like Medicare and Medicaid need to be reined in because of the growing federal budget deficit. He also has called for cuts in non-defense discretionary programs like senior housing and services and supports. If Republicans hold onto the House, there is the danger that the House would go along with whatever the Senate may do to cut these programs.

If Democrats take over one or both houses, their leadership may have to deal with promises some Progressive candidates have made about “Medicare for all”. These candidates have not outlined any realistic way to pay for this proposal and the federal budget deficit would be a barrier against any significant expansion of Medicare.

While Democratic candidates have criticized last year’s tax cut, none of them has promised to roll it back.

Immigration has been an issue in many campaigns, but there seems to be little consensus around any kind of reform. Realistically speaking, any bill Congress passes will come up against President Trump’s priorities.

This year, LeadingAge has held town halls all around the country. While we are still formulating our policy objectives for next year, we expect to be active in the following areas:

  • Opposition to any cutbacks in the Medicare and Medicaid programs that finance 70% of long-term care;
  • Advocacy for maximum possible funding for senior housing and home- and community-based services;
  • Reintroduction of H.R. 6986, the Nursing Home Workforce Quality Act, to end the mandatory certified nursing assistant training, lockout, and other regulatory relief, especially in nursing homes;
  • Long-term services and supports financing reform. An initial concept paper was put forward earlier this year by Rep. Frank Pallone (D-NJ), who could become the Energy and Commerce Committee chair if the Democrats take a majority in the House.
  • Immigration reforms that would help our members recruit more workers;
  • Other workforce development legislation, including a reintroduction of H.R. 3778, the Direct CARE Opportunity Act, sponsored by Rep. Bobby Scott (D-VA); and H.R. 3461, the Improving Care for Vulnerable Older Citizens through Workforce Advancement Act sponsored by Rep. Matt Cartwright (D-PA).