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How could midterm elections impact ASCs?

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On Capitol Hill, ASCs are the little guy. The hospital lobby is powerful, and though the Patient Protection and Affordable Care Act has thrown some bones to the ASC industry lately, the ASC position in Washington, D.C., is at times precarious.

Midterm elections will be held November 4, 2014, with all House and 33 Senate seats contested. One of the most controversial issues widely expected to affect which candidates emerge from their races victorious is the PPACA. But will a change in the partisan dynamic have an impact on ASCs?

Politically speaking, a Congressional changing of the partisan guard seems likely. As of the end of July, a CBS News/New York Times Battleground Tracker poll based on interviews of 100,000 registered voters predicted a Senate victory, 51-49, for the Republican Party. The Senate is currently under Democratic control, with Democratic Senators outnumbering Republican Senators 53-45, and two independent senators aligning with the Democrats.

The House of Representatives, which is currently under Republican Control, is expected to remain so, especially as the Democratic Party is trailing behind the Republican Party on a number of key engagement indicators, according to a July 2014 survey from the Pew Research Center.

According to William Prentice, CEO of the Ambulatory Surgery Center Association, even with the Republican Party's strong positioning for the 2014 midterm elections, the legislative climate isn't likely to change within the next few years, especially because of the Democratic president's power to veto any conservative legislation he feels may undermine his goals for the PPACA — his probable legacy.

"What you can see happening over the next two years in any scenario is that they will be like the past couple of years — with not much legislative activity. There will be table-setting for 2016," he said. Even payments to ASCs may not get much of a boost, due to the budget climate, though he expects Congress to revisit the issue of site neutrality: "It will continue to get attention and could be an issue of value to ASCs," said Mr. Prentice.

More important than midterm elections are 2016 elections and beyond. After political jockeying has concluded and efforts to get rid of the PPACA die down, Mr. Prentice hopes legislative activity will focus on honing the healthcare law and looking ways to fix some of the obvious solutions. "Once the heat dissipates after the election, we could see majorities in both houses circle around good solutions," he concluded.

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