As members of the 116th Congress arrived in Washington, D.C., in early January, they ushered in a different political environment. Unlike the 115th Congress—where Republicans controlled the White House, Senate and House of Representatives—last November's midterm elections resulted in a divided Congress, with Republicans retaining the majority in the Senate and Democrats taking the House.
Now, the legislators are focusing on electing their leadership, making committee assignments, and new members are staffing their offices. During this time, children's hospitals are meeting their new legislators, and there are many new legislators to meet. Newly elected lawmakers will fill 10 percent of Senate seats and 20 percent of House seats. These discussions with their local children's hospitals and CHA staff focus on discussing the uniqueness of children's hospitals and the role that Medicaid plays in children's health.
The meetings and the continued outreach to returning members are focused on developing new and stronger champions for children. While building strong ties with every member of Congress is important, particular attention must be paid to members of the key committees with jurisdiction over children's health care issues, such as the Appropriations, Senate Finance, and House Energy and Commerce Committees.
When everything is settled, and Congress can begin its agenda, most experts say a divided Congress will produce gridlock and partisan conflict that will make the passage of legislation difficult. For children's hospitals and other Medicaid advocates, a partisan split between the two chambers makes the possibility of sweeping legislative changes to entitlement programs like Medicaid remote.
However, more targeted Medicaid threats to provisions like supplemental payments will remain on the table, as will continued scrutiny of the 340B Drug Pricing Program, and efforts to address surprise billing and challenges with drug prices. It's expected the Trump administration, along with state governments, will advance administrative regulatory actions that could affect children's health.
Even with divided government, children's hospitals will need to be active in Washington to protect Medicaid, and continue looking for opportunities to improve this program so vital to children's health.