Providers should pay special attention to what happens in the Senate tomorrow

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John O'Connor
John O'Connor

Tomorrow's the big day.

All across this nation, voters will go to the polls to elect three dozen governors and every member of the U.S. House of Representatives— in addition to thousands of state, county and local officials.

But these are relatively trivial matters compared to the contests providers will really need to monitor. That's because the various U.S. Senate-race outcomes could potentially change the way many operators do business.

With momentum growing by the hour, it appears Republicans are poised to take control of the Senate. And in the very possible event that this occurs, the GOP will control both chambers of Congress for the first time in two decades. The obvious implication is that such a result will almost certainly lead to gridlock. But that's a superficial reading at best.

Should Republicans take control of both chambers, you can bet your last dollar that Obamacare will be targeted for defeat. The GOP-controlled House has already passed 30 measures that would repeal part or all of the Affordable Care Act. It's a certainty the same would also start happening in the senior chamber.

You can also safely bet that President Obama would veto such legislation, once it reaches his desk.

So if Obamacare is to be overturned in the next two years, you'll probably have judges to thank or blame. That is, unless Republicans can achieve a veto-proof 60-member majority. That outcome appears to be a long shot, but stranger things have occurred. And should it happen, we can say bye-bye to the ACA. Gone will be accountable care organizations, the law's incentives and options for expanding home- and community-based care, and demonstration projects that target chronic care coordination, dual eligibles and nursing home quality. And as for that little matter of mandated health insurance for employees? Kaput.

But again, that's only if the GOP hits 60 votes.

However, with even a simple Senate majority, Republican lawmakers will be in a position to impose their will. So things like a higher minimum wage, restrictions on financial institutions, cleaner water rules and other Obama-agenda items would almost certainly be squashed.

More significant is that the government could soon be shutting down again. It's all but guaranteed that a GOP-controlled Congress would be approving budgets with priorities and provisions the White House detests. Faced with the prospect or going along or rejecting such spending plans, it's a safe bet the president would choose the latter option. So if you thought sequesters were a nuisance last time around, just wait.

The Center for Responsive Politics predicts that almost $4 billion will be spent on this year's midterm elections.  Considering what providers might have to deal with on Wednesday, it may be hard to argue that the money was well spent.

John O'Connor is McKnight's Editorial Director.

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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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