Trump, man of mystery

Stakeholders latch on to president-elect’s stances on small government
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Friday, November 11, 2016

WASHINGTON – Industry stakeholders are looking ahead at what a Trump presidency could mean for HME.

“If it was anyone other than Donald Trump, I would be able to tell you a lot more,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “He’s not a traditional Republican. It’s unclear what his congressional agenda is and what his proposals really mean.”

What is clear is that Trump, a businessman with no political experience, struck a chord with Americans who are fed up with politics as usual.

Trump certainly resonated with HME providers, who say they are burdened under the weight of Medicare’s competitive bidding program and an environment of general over-regulation. In September, 64% of respondents to an HME Newspoll said they’d vote for Trump.

“Trump’s mantra is that he wants to slash regulations, he wants to slash bureaucracy—that’s all great for DME,” said John Gallagher, vice president of government relations for The VGM Group. “One of the problems we’ve had is, because of the divided government, none of the committees of jurisdiction had control over CMS. CMS being put back in its bottle would be tremendous.”

With both the White House and both chambers of Congress soon to be under Republican control, stakeholders say they expect a more sympathetic ear to the industry’s plight—especially from lawmakers representing rural America, which came out in droves to support Trump.

“Rural America has been forgotten for a long time,” said Gallagher. “Trump’s speech said, we are going to bring jobs back, so we have to make sure we are talking to our members of Congress abut the same thing. We have got to have rural relief (from competitive bidding), and particularly the delay (of the second round of cuts on July 1), to save these businesses before they are gone.”

On a higher level, a big question on everyone’s mind: What about the Affordable Care Act? Trump has vowed to repeal the program, but whether he tries for a complete repeal or keeps certain provisions in place is uncertain.

“There’s a lot of speculation, but we are really focused on the next three or four weeks and getting (bid relief) passed,” said Jay Witter, senior vice president of public policy for AAHomecare. “It’s all about the leadership and the mindset: What can you get done? I think they are still sorting it out.”

In addition to the 20 million Americans who have obtained health insurance through the ACA, the act has also initiated many programs—like those reducing hospital readmissions—that put more emphasis on post-acute care, including the role of HME providers, say stakeholders.

“Everybody would agree that post-acute care is where people get more care at less cost,” said Bachenheimer. “There are so many ramifications in terms of dismantling some of these huge things that Health and Human Services has moved forward.”

Stakeholders who visited Capitol Hill in the days after Trump’s upset say the shock is palpable, but they feel good about the industry’s chances of getting bid relief passed in the lame-duck session, particularly since its champions, including Rep. Tom Price, R-Ga., won re-election.

“We feel strong and good,” said Tom Ryan, president and CEO of AAHomecare. “We need help now. We are losing infrastructure and businesses daily. That was the message a week ago and that hasn’t changed.”