The new Congress is organized, committee assignments have been made, and members are staking out issues. This year there will be substantial discussion about Medicare, prescription drug coverage, long-term care, and extensive debate over the war in Iraq. The Democratic takeover during the midterm elections of 2006 has changed committee chairmanships important to the HME industry.

THE SENATE FINANCE COMMITTEE

The Rules of the Senate specify that the Senate Finance Committee shall have jurisdiction over "health programs under the Social Security Act (Medicare) and health programs financed by a specific tax or trust fund."

The Rules of the Senate allow for subcommittees, but historically, major policy issues—especially health care issues—have been handled by the full Senate Finance Committee. Sen Chuck Grassley (R-Iowa) handed the chairman's gavel to Max Baucus (D-ND). The collegial nature of the Senate and the Democrats' one-vote majority will force Baucus and Grassley to continue to work closely. The industry has a relationship with Grassley and needs to build one with Sen Baucus.

There are other members of the Senate Finance Committee who have shown an interest in home care and HME issues. Largely because of the hard work done by Tom Ryan and the New York Medical Equipment Providers Association (NYMEP), Sen Chuck Schumer (D-NY) has shown an interest in home oxygen services—as have Orrin Hatch (R-Utah) and Trent Lott (R-Miss), again largely due to local providers' efforts.

Sen Ken Salazar (D-Colo), the newest member of the Senate Finance Committee, has beefed up his health care staff and has signaled that he is "approachable and interested" in the promise of home-based health care.

Unlike the Senate, the House of Representatives tends to be much less collegial. Just as the Republicans ignored the Democrats for 12 years, it is apparent that the Democrats are less respectful of Republican members' past accomplishments, positions, and interests. Adding to the chaos, some old names have resurfaced in positions of power on the House side of the Capitol.

HOUSE WAYS AND MEANS COMMITTEE

Like the Senate Finance Committee, Ways and Means has jurisdiction over Medicare and health programs financed by specific taxes or trust funds. Pete Stark (D-Calif) now has the gavel wielded for the past 12 years by industry nemesis Bill Thomas (R-Calif), who has retired. Like his predecessor, Stark has named himself chairman of the Health Subcommittee.

The key to getting the chairman's attention on other matters may be in the hands of three relatively new members of the Health Subcommittee. Earl Pomeroy (D-ND), Rahm Emanuel (D-Ill), and Stephanie Tubbs-Jones (D-Ohio) have all shown an interest in home care as a way of reducing Medicare costs for long-term care. Emanuel served on the domestic policy staff of President Clinton and is familiar with the issues associated with the industry and home care in general.

Aside from the members listed previously, the industry has enjoyed the patronage and support of certain members who were not on committees with jurisdiction over Medicare or health care policy. The industry's "go-to guy" in the House during the 12 years of Republican control has been Rep Dave Hobson (R-Ohio). Hobson remains a strong supporter of the HME industry, and as a ranking member of an appropriations subcommittee, he has the ability to rally Republican support. Further, Hobson is a "horse trader" and will be able to influence members from both parties who are seeking funding for special projects in their home districts.

Democrat Sherrod Brown of Ohio moved from the House to the Senate, taking with him what many Washington insiders referred to as one of the best health staffs on Capitol Hill. Sen Brown has been appointed to the Committee on Health, Education, Labor, and Pensions (HELP). He will sit beside Sen Edward Kennedy (D-Mass) and Sen Hatch as a member of the Subcommittee on Health and Retirement. This subcommittee will be addressing issues important to the HME industry such as long-term care services for older Americans, family caregiving, and health of the aging population.

This is certainly not a complete list of the members of Congress who can be helpful to the HME industry. As always, the key to success is nurturing established relationships and building new ones. Despite the new Democratic majority, the Senate will function much as it did under Republican control. The House, on the other hand, requires a new strategy—and frankly—some fence-mending with too-long-ignored Democrats who are now in leadership positions.

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