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How the Midterm Elections Will Affect Aging Policy

The results of the 2018 midterm elections will have significant implications on the nation’s public policy agenda—including issues affecting older adults—over the next two years.

Changes in the House

Democrats could pick up as many as 40 new seats, establishing an anticipated 234-201 margin, taking control in the House. That means, House Democrats can lose only 16 votes within their party to pass legislation. So, the 20-25 conservative Democrats, also known as “Blue Dogs,” who could represent swing votes, will likely have increased influence in the House.

It is not certain whether current Democratic Leader Nancy Pelosi (D-CA) will be able to secure the votes needed to be the next House Speaker. Several candidates who won office, as well as several current Democratic members, have said they will not support her. The Democratic Caucus election is Nov. 28, with a full floor vote Jan. 3, 2019. No one has formally announced an opposition candidacy, so conventional wisdom is that Pelosi will become the next Speaker, and some are speculating that an agreement will be reached for her to serve no more than two years.

Other new leaders in the House will include chairs of important committees that address senior issues.

  • House Ways and Means Committee: Richard Neal (D-MA) will chair this committee that has jurisdiction over Medicare, Social Security, and tax issues. The chair of the Health Subcommittee will be either Lloyd Doggett (D-TX) or Mike Thompson (D-CA).
  • House Energy and Commerce Committee: Frank Pallone (D-NJ) will chair this committee that has jurisdiction over Medicare and Medicaid issues. The Health Subcommittee chair will be Anna Eshoo (D-CA).
  • Appropriations Committee: The new chair will be Nita Lowey (D-NY), and the chair of the Labor, Health and Human Services, and Education Subcommittee will be Rosa DeLauro (D-CT).
  • Education and Labor Committee: Bobby Scott (D-VA) will be the new chair of this committee, which will oversee the reauthorization of the Older Americans Act (OAA) in 2019.

Changes in the Senate

In the Senate, Republicans gained two seats for a margin of 53-47. Mitch McConnell (R-KY) will continue to be the Senate Majority Leader, with Chuck Schumer (D-NY) continues as Minority Leader. Moderate Republicans such as Susan Collins (R-ME), Lisa Murkowski (R-AK), and Mitt Romney (R-UT) are expected to be key swing votes.

One important leadership change is that Chuck Grassley (R-IA) will take over as chair of the Senate Finance Committee which has jurisdiction over Medicare, Medicaid, Social Security, and tax issues, replacing retiring Orrin Hatch (R-UT).

The Policy Agenda

With the Democrats in control of the House, fears about key programs being cut are eased. If Republicans had retained control of the House, Senate, and White House, many expected they would continue to try to repeal the Affordable Care Act (ACA) and significantly cut and cap Medicaid, which helps about 7 million low-income seniors. There were also fears that Republicans would attempt major cuts to Medicare, OAA and other discretionary appropriations, and potentially Social Security to help pay for the $1.5 trillion increase in the deficit due to last year’s tax cuts.

House leaders, instead, are expected to focus on several other key health care issues, including reducing prescription drug costs, Medicare for All proposals, and stabilizing the ACA. Other priorities will likely include climate change, immigration, gun safety, voting rights, and infrastructure, as well as several investigations of the White House.

Some of these bolder House issues have little or no chance of passing the Republican Senate and being signed into law by the president. However, some compromises can be made to gain bipartisan support and move through to final passage.

NCOA Priorities

NCOA is focused on advocating for several issues of concern to older adults:

  • Program funding: A two-year deal reached earlier this year raised budget caps and maintained approximate parity between defense and non-defense discretionary spending. A new deal will have to be negotiated next year, and if no agreement is reached, sequestration will return for FY20 and FY21. If that happens, non-defense discretionary programs (which includes the OAA) will be cut by approximately $55 billion in FY20 alone.
  • Social and Behavioral Determinants of Health (SBDOH): NCOA is seeking to improve access to SBDOH, including increasing funding for evidence-based programs under the Prevention and Public Health Fund and improving access to Medicaid Home and Community-Based Services (HCBS). We are working to extend the Money Follows the Person (MFP) program and spousal impoverishment protections, and to craft legislation to strengthen and continue the ACA Balancing Incentives Payment (BIP) program. We are hopeful that MFP will be extended for at least one year during the “lame duck” session this December.
  • Health care extenders: Several important programs are due to expire Oct. 1, so some action on Medicare and Medicaid is expected next fall. NCOA is particularly concerned that authority for low-income Medicare outreach and enrollment efforts is among those that need to be extended. NCOA will be working to make the funding permanent.
  • Older Americans Act: The OAA is due to be reauthorized in 2019. NCOA will seek to strengthen the OAA, both through increased appropriations and reauthorization.
  • House Select Committee on Aging: NCOA is leading the effort to reestablish this committee that was disbanded 25 years ago and the Leadership Council of Aging Organizations (LCAO) coalition supports this action. While the House committee would not have specific authority over legislation, it could increase understanding and raise the visibility of the challenges and opportunities presented by our aging nation and promote well-informed improvements and solutions.

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Howard Bedlin

About Howard Bedlin

Howard Bedlin is NCOA's Vice President of Public Policy and Advocacy. He is responsible for all of NCOA’s federal and state legislative advocacy efforts on issues and programs of concern to older adults, which include the Older Americans Act, Medicare, Medicaid, long-term care, income security, and community services programs.