For years, the HME services industry has focused most of its resources on the Senate Finance and House Ways & Means committees. Without question, these two committees have profound influence on industry issues and the final say on certain Medicare proposals. However, it is time for the industry to look at Congress with a wider lens. There are several other committees in both the House and Senate that deserve more of the industry’s time and resources.

The Subcommittee on Health of the House Energy and Commerce Committee has oversight over Medicaid and Medicare Part B. Former Chairman Billy Tauzin (now a lobbyist for the pharmaceutical industry) ceded authority for most of the health care agenda to powerful Ways & Means chair Bill Thomas (R-Calif). However, the new chairman, Joe Barton (R-Tex)—a strong proponent of competitive bidding —is anxious to make his mark on health care issues. His minority counterpart, Sherrod Brown (D-Ohio), is a long-time supporter of industry issues.

In both the House and Senate, the Appropriations Committees have lots of power. The main reason for this is that these committees have the final say on whether special projects (eg, parks, military bases, federal research facilities) will be funded. Funding a big federal facility, with its accompanying jobs, in any state or district gives appropriators a lot of say on issues they care about.

For example, one of the industry’s biggest supporters, Rep Dave Hobson (R-Ohio), has been able to negotiate for the industry because of his position as the chairman of the Appropriations Subcommittee on Military Construction until 2003. Now he is the chair of the Energy and Water Development Subcommittee, an important position for legislators from agricultural states.

Another group that has proven it can weigh in on industry issues is the Small Business Committee. Job growth in America, in fact the economic future of the country, depends on small businesses. Experts estimate that seven out of every 10 new jobs created over the next 10 years will be in businesses with 50 or fewer employees.

This will serve to elevate the profile and the power of these committees in the House and Senate. Add to this the fact that the majority of HME providers are small businesses and you can see why these committees can be important allies.

There are several other committees that should be brought up to speed on industry issues. In the Senate they include the Health, Education, Labor and Pensions; Commerce; Science and Transportation; Budget; and Special Committee on Aging.

On the House side, there are the Budget, Veterans Affairs, and Education and the Workforce committees. In both chambers, the Rules Committee decides what committee a piece of proposed legislation will be assigned to and when legislation is sent to the floor for a vote. Rules committees can kill a piece of legislation by not assigning it to a committee or not releasing the committee’s recommendations for a floor vote.

Even though Republicans control both chambers, members of the leadership teams of both parties are powerful individuals. Horse trading and compromises are ways of making any issue “bipartisan” and thus a way for the minority to influence legislation.

Beyond the complex committee structure, the linchpin of any successful effort to influence legislation is found at the grassroots. If a member is convinced that crucial voters support or oppose any legislative proposal, committee reports and pressure from party leadership will be weakened.
This is the point where, in a close vote, freshman legislators can get the leadership to agree to support them on unrelated issues. This is where first-term legislators can vote for something they don’t like to get favorable treatment down the road on an issue important to them.

Counting the vice president, there are 536 voting members of Congress. Any one of these members can change the course of history. A passionate legislator, backed by an active and vocal constituency, can dig in his or her heels to stop onerous provisions or pass proposals not popular with the leadership or the White House.

The worst thing we can do is ignore any member of Congress. The industry would be ill served if it sent the signal—even unintentionally—that even one of those 536 voters is not important enough or not assigned to the “right” committee to seek interest and support. Such mistakes can’t be easily corrected.

Cara C. Bachenheimer, JD, is vice president of government relations for Invacare Corp, Elyria, Ohio. David T. Williams is a consultant for political and legislative strategy.