It is likely that the current Republican leadership will leave anything that has to do with Medicare to the next Congress. This is not a bad thing. A Democratic Congress may be more willing to question actions taken by a CMS that is part of an “opposition administration.”

The long-awaited November elections are now history, and the landscape of Washington has changed dramatically. Last month, internal pollsters from both political parties began to hint that “they were seeing trends that could possibly result in Democrats picking up enough seats to take control of the House by the narrowest of margins” and that Democrats could pick up as many as three seats in the Senate. But no one thought that the Democrats would come away with a 236 to 199 House majority. Make no mistake. The Democratic Party will control the House of Representatives in the 110th Congress.

The Republican Party’s election nightmare grew worse when it lost four hotly contested races and three “safe seat incumbents”—Lincoln Chafee (R-RI), Conrad Burns (R-Mont), and George Allen (R-Va). The idea that Democrats would win enough races to take control of the Senate was a long shot. But sometimes long shots pay off, and now Democrats have a 51 to 49 majority.

Even though his term does not end for another 2 years, President George W. Bush was severely wounded in the midterms. Members of his own party blame him for the losses in the midterm elections. And anything his administration tries to get done during his last 2 years in office will require the acquiescence of a Congress firmly in the control of the opposition.

What does this mean for the HME, home oxygen therapy, and rehab markets? From a practical standpoint, there will be a whole new power structure in the 110th Congress. The chairmen of all committees and subcommittees in both the House and Senate will change. For example, industry nemesis Bill Thomas (R-Calif) will be replaced by Charlie Rangel (D-NY). This could be good news because Rangel has often voiced support for industry issues. However, staunch supporters such as Dave Hobson (R-Ohio) will be weakened with Republicans in the minority.

On the other side of the Capitol, Max Baucus (D-Mont) will replace Chuck Grassley (R-Iowa) as Chairman of the powerful Senate Finance Committee—and the membership of this committee is likely to change before the new Congress is sworn in on January 4, 2007. In the big picture, the Democrats’ slim majority will keep Republican influence alive—but muted—in the Senate.

What about industry issues that are currently before Congress? Initiatives such as the Home Oxygen Patient Protection Act (HOPP), the Hobson/Tanner bill to curb competitive bidding, and the rehab carve-out bill did not get addressed during the post-Thanksgiving lame-duck session. Any legislation that does not get passed before the 109th Congress adjourns will have to be reintroduced after the 110th Congress is sworn in.

It is likely that the current Republican leadership will leave anything that has to do with Medicare to the next Congress. This is not a bad thing. A Democratic Congress may be more willing to question actions taken by a CMS that is part of an “opposition administration.”

The first thing the industry should do is pay attention to the 44 new members of the House of Representatives. Every effort should be made to contact them and educate them on the issues important to the industry. A truly coordinated grassroots campaign involving providers, clinicians, and, most important, consumers must be up and running no later than January 1. Any campaign should be armed with short issue briefs, suggestions on how to help solve the problem, and testimonials from constituents adversely affected by CMS’ actions. Most important, participants should be among the first visitors to a new member’s office.

At the same time, industry leaders and lobbyists need to reintroduce themselves to Democrats in the House of Representatives. Like many special interest groups, the industry paid much more attention to Republican House members for the past 12 years than to Democrats. Moreover, the majority of the political fundraisers sponsored by the industry and its leadership for the past 8 years were to benefit incumbent Republican lawmakers. Suffice it to say, there are fences to mend.

The midterm elections have provided the industry with the opportunity to take its issues to new sets of eyes and new committee structures that may be more sympathetic. But it will take a well-coordinated effort, and it will require a few people to swallow their pride.

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