election 2016 predictions and impact · • resolve “family glitch” that denies insurance...
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Election 2016Predictions and Impact
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Candidates for President of the U.S.
ELECTORS OF PRESIDENT AND VICE PRESIDENT
• CLINTON and KAINE, Democratic
• JOHNSON and WELD, Libertarian
• STEIN and BARAKA, Green-Rainbow
• TRUMP and PENCE, Republican
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What issues do voters care about? Pew Research Center, July 16
• Economy & Terrorism The economy and terrorism are the top two issues
for voters this fall. Overall, 84% of registered voters
say that the issue of the economy will be very
important to them in making their decision about
who to vote for in the 2016 presidential election;
slightly fewer (80%) say the issue of terrorism will
be very important to their vote.
Other issues that rank highly on voters’ 2016
importance list include foreign policy (75% very
important), health care (74%), gun policy (72%) and
immigration (70%).
With an open seat on the Supreme Court, 65% say
appointments to the nation’s highest court will be a
very important factor in their decision this fall.
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Presidential Polls
• National PollsAccording to a recent ABC News and ABC
News/ Washington Post polls, Hillary
Clinton up 12 percentage points over Donald
Trump among likely voters, 50 to 38 percent
Up 7 points since Oct. 13
CNN Poll out this week has a narrower
margin, 5%
• Polling of Massachusetts VotersClinton has an over 24% lead in
Massachusetts
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Six Consecutive Presidential Elections
Source: 270towin.com
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Electoral College Map
Source: 270towin.com
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• Donald Trump• Repeal Obamacare
• Promises no cuts to
Medicaid
• Convert Medicaid to
block grant, ending the
open-ended federal
entitlement and capping
federal funding
• Enforce immigration
laws. Claims U.S.
provides healthcare to
illegal immigrants,
costing $11B annually.
• Hillary Clinton• Expand Medicaid in
the 19 states
• Three years of full
federal funding for 19
states (same as
originally offered
when passed)
• Allow people ages 55-
64 to buy into
Medicare
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• Donald Trump
• Repeal
Obamacare
• Promises not to
Cut Medicare
• Support drug
importation
• Hillary Clinton• Authorize Medicare
to negotiate drug
prices with Pharma
• Supports beneficiaries
importing lower-cost
Rx from abroad
• Allow people ages 55-
64 to buy into
Medicare
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• Donald Trump
• Nothing in
Health Care Plan
• No response to
NACHC inquiry
on funding cliff
• Answer to ACA is
to increase
funding for more
CHCs
• Hillary Clinton• Double funding for CHCs
and support healthcare.
• Double funding for
primary-care services at
CHCs over the next decade.
• Supports President
Obama’s call for a near
tripling of size of National
Health Service Corps.
• Favors 3.6B Mandatory over
10 years, 36B, plus
additional growth funds
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• Donald Trump• Completely Repeal
Obamacare
• Eliminate individual mandate
• Tax deduction for health
insurance premiums. Allow
individuals to fully deduct
insurance premium payments
from their tax returns
• Allow insurance companies to
sell across state lines
• Allow individuals to use
Health Savings Accounts.
• Price transparency from all
healthcare providers,
especially docs and healthcare
organizations like clinics and
hospitals.
• Hillary Clinton• Defend and Strengthen ACA
• Resolve “family glitch” that
denies insurance subsidies to
some dependents
• Sweeten Subsidies for people
buying coverage in marketplace
• Offer a new government-
sponsored insurance plan to
compete with private companies
• Hillary Plan to expand coverage
to 9 million more uninsured
• Repeal tax on high-cost
insurance “Cadillac Tax”
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U.S. Senate
Republican
54
Democrat
44 D, 2 Ind.Current Senate
+16 +10
46 46
Seats not up for Reelection 30 34
Solid Party Seats
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Competitive U.S. Senate Seats
Republican
Rubio (I)
Portman (I)
Kirk (I)
Johnson (I)
Ayotte (I)
Democrat
Murphy
Strickland
Duckworth
Feingold
Hassan
Florida
Ohio
Illinois
Wisconsin
NH
48 49
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Competitive Senate Seats Cont.
Pat Toomey (I)
Todd Young
Richard Burr (I)
Katie McGinty
Evan Bayh
Deb Ross
Pa.
Indiana
NC
48-51 49-52
2018 US Senate ?!
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U.S. House of Representatives
Republican
247
Democrat
188Current House
Solid Incumbent Seats
Likely Outcomes
(435)
(378)
(417)
228 189 (+5)
201
+27
177
+12
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U.S. House Cont.
18 Seats
• 15 current R (5 open)
• 3 current D (2 open)Toss Ups:
Predictions: • Dems gain 5-20
• Highly unlikely to get 30
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• In September 2016, a Kaiser Family Foundation
Conducted a Health Tracking Poll
• Favorable or Generally Unfavorable Opinion
of Health Reform Bill signed into law in
2010 (“Obamacare”)?
47% Unfavorable (down 2% since April)
45% Favorable (up 7% since April)
• New Government Report on ACA likely to
drive up Unfavorability in October
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• According to Government Report Released on
Monday, ACA Costs Surge.• Average premium for Benchmark Silver Plan will
rise 22% in 2017 in states that use federal exchange
• Typical bill will be $296 a month for 27-year old
• Last year, Premiums rose only +7.2%
(double pace of inflation)
• However, 75% of Policy Holders will pay less than
$100 per month with Gov’t Subsidies
• 2017, number of Carriers will drop to 228 (down 70) in
Federal Exchanges and selected states
• Insurers narrowing networks to keep costs down
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• Enrollees Sicker and More Costly than
Expected
• Lack of Young, Healthy Enrollees
• Insurers Priced Plans Too Low
(Adjusting)
• Fewer Companies Offering Coverage
Dropping Exchanges
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State of Play in Massachusetts
• Most lawmakers did not face re-election
challenges and even fewer face opponents in 2
weeks
• 15 of 40 Seats in the Mass Senate Contested
• 42 of 160 Seats in the Mass House Contested
• 7 of 14 Sheriffs Contested
• Legislators on Road for Presidential Candidates
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Massachusetts Senate
40 Mass. Senators: 34 D, 6 R
3 Open Seats:
Wolf (D): Cyr (D) vs. Schiavi (R)
Downing (D): Hinds (D) vs. Canning (R)
Joyce (D): Timilty (D)
3 Contested Republican Seats:
O’Connor, Humanson, Ross
All likely to remain
9 Contested Democratic Seats:
L’Italien (D) vs. Laplante (R)
Gobi (D) vs. Erhardt (R)
Lesser vs. Harrington (R)
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Massachusetts House of Representatives
160 House Members: 126 D, 34 R
9 Open Seats:
All current Democratic seats
Likely 8/9 will stay D
J. Fernandes (D): Biagetti (R) vs. Murray (D)
15 Contested Republican Seats:
Likely 11/15 will stay R
Wong/Migliore, Decoste/Nyman
Viera/Patrick, Boldyer/Sandlin
8 Contested Democratic Seats:
Likely 5/8 will stay D
Gregoire/Ferro, Mom/Kay
Cutler/Cogliano
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• Question 1•
• Question 2•
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• Question 3•
• Question 4•
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• State Facing 9c Cuts• $294 million gap between anticipated revenue
collections for fiscal 2017 and budgeted spending
• House Speaker and Senate President calling for Baker
Administration to “pump the breaks”
• Gov. says municipal and school aid, funding for DCF
core services, higher ed, court system, DMH,
pensions, debt service and budgets of other four
constitutional officers off limits
• Mass Medicaid Waiver Approval Pending
• Governor 69% Job Approval Rating, but no
progress on key legislative priorities (e.g., charter schools)
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•U.S. House and Senate both
put forward $1.5B for
discretionary funding
•FY2016 levels carry forward
through CR, back in December
to pass budget appropriations
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• 30 Programs expire over next 2 years,
largest CHC mandatory funding and CHIP
• $3.6B out there being used by CHCs
• No clear legislative vehicle, nothing like
Medicaid Doc Fix
Fix Options
1. Move $3.6B to discretionary, moves us
beyond cap under discretionary funding
2. 10-year fix, considered permanent
3. Kick forward with shorter multi-year fix
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• Only 2/3 of Massachusetts FQHCs are
members of NACHC
• Expect 50% of Congress to turn over in
four years
• must re-educate members
• build new relationships
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Questions?