President Barack Obama gets another four years to roll out specific provisions of health care reform that had been on hold up to now. But his first priorities include the pending 27% SGR cuts and the fiscal cliff he faces even before his next inauguration.
So much for celebration. Get back to work, Mr. President.
And he may not even get four years to fully govern; he may only get two, an expert chided.
Policy wonk Tom Miller of the conservative American Enterprise Institute told Modern Healthcare that health care reform, "may regain political significance for Republicans if there are major implementation problems with its major provisions in the run-up to the 2014 mid-term elections."
With the federal government remaining in control of the incumbent, the focus is going to shift to the states, especially on issues of Medicare and Medicaid funding. And consider the examples of Texas and Vermont, where the state-by-state health insurance exchanges mandated by health care reform are being set up as bare-bones plans, or single-payer plans are under consideration, respectively. Missouri voters approved an initiative to block creating an exchange unless the legislature authorizes it, while Florida voters rejected an effort to block Obamacare's major provision that people buy health insurance or pay a penalty.
ACP's own Bob Doherty writes, "The election doesn't settle which choice the country will make, except that it will not be repealed. But I hope that when realization sets in among the public that ObamaCare won't be repeated, there will be a renewed willingness to take what is good about the law, especially coverage of the uninsured, and make changes where needed (how about real medical liability reform as a start?) to make it better."
John Schumann, MD, FACP, started two days before the elections with his preview of things to expect: health care will be divisive, increasingly more expensive, and changing, "so much so, that I predict by the 2020s your basic conception of 'health care' and how you interact with the system will be vastly different than it is now."
ACP members (whose tweets can be collectively followed here) tweeted a full spectrum of elections-related opinions, from congratulations to the incumbent or other winners, to state-by-state breakdowns on legislative races to issues such as medical marijuana, assisted suicide and genetically modified food. One tweet from Ryan Madanick, MD, ACP Member, summed it up best: "The best part about Election Day is that tomorrow we can all go back to watching REAL commercials again!"