It's a new year, new politicians are in power, and they are looking to make a mark. When Democrats encounter opposition to their agenda, they say, "You promised to be bipartisan!" Translation: "How dare you stick to your principles!" If the Republicans had suddenly shifted into power, the exchange would be no different. Then again, government gridlock has served the country well in the past, so perhaps a divided Congress and Executive Branch is a good thing after all.

The good news is that home care issues seem to strike a uniquely bipartisan tone. A cursory glance at Hobson-Tanner supporters yields a roughly equal number of Democrats and Republicans. With this in mind, state associations, buying groups, and AAHomecare staffers have already begun conversations with Congressional offices to test the waters for a repeal and/or revamping of competitive bidding.

And yes, despite the lack of a final rule at press time, the dreaded competitive bidding is still firmly in place for 2007. However, a legislative remedy in the form of a revived Hobson-Tanner bill and/or its Senate Hatch-Conrad companion could eliminate competitive bidding's most onerous provisions. Be sure to check the Top News section (home page, top left) of our website every day for full coverage of the final rule when it comes out—and despite the irksome delay, it will come out.

Meanwhile, some major health initiatives are in play, particularly in California where Governor Arnold Schwarzenegger has proposed a plan to mandate health insurance for almost all of California's 6.5 million uninsured. My knee-jerk reaction to a plan of this ilk is to run screaming. While I don't know the details of the governor's plan, I fear any scheme that will inevitably lead to price controls once costs spiral out of control.

HME Today editorial advisory board (EAB) member Bob McCoy, RRT, also has reservations about the plan. "Having insurance does not mean you will get health care," says McCoy, managing director at Valley Inspired Products, Apple Valley, Minn. "The health care system is focused on devices to treat people. They don't! People treat people and devices are only tools in the hands of a skilled clinician. This legislation is another form over function process. If we paid for outcomes rather than devices, we would save money rather than waste it. This plan will not solve the problem."

EAB member Larry Rice, chief operating officer for In Home Products Inc, Dallas, thinks harm to businesses may outweigh any benefits. "What cost will this plan impose on businesses?" asks Rice. "Will it put further stress on our limited federal funds that may subsidize the program? Insurers may provide affordable packages that meet only the basic requirements...and will we fund this through increased taxes?"

Add on Schwarzenegger's provision to cover all of California's illegal immigrants and you have a political hot potato that will be hard to swallow. Whatever happens, expect a robust debate in the Golden State.

Greg Thompson