November 2014NADPac Report

Political Action Committee

In this issue:Washington Insider

New Governors & HCR

State Election Results

NADPac 2014 Contributors

NEW GOVERNORS COULD CHANGE STATE COURSE ON HEALTH CARE REFORM

FAST FACTS

WASHINGTON INSIDERCapital Updates with Lisa Layman

NADPac Report November 2014

114th U.S. Congress1/3/15 - 1/3/17

Senate (100)

Senate Party Standings(as of 11/6/14)

52 Republicans45 Democrats

3 Undecided

House of Representatives (435)

House Party Standings(as of 11/6/14)

243 Republicans179 Democrats

13 Undecided

The Republican victory on Election night was swift and decisive. The GOP set the stage for the evening early in Kentucky: in what was supposed to a viable pick-up seat for the Democrats, Senator Mitch McConnell was re-elected handily, defeating Democrat Alison Lundergan Grimes by 15 points, minutes before 7 pm ET.

A map favoring the GOP, widespread voter dissatisfaction with the President, and disciplined Republican candidates upended speculation that control of the Senate might not be determined until January 2015 (due to runoff races) and made it an early night. Republicans were halfway to their needed six seats for the majority by 9 pm, and had seized control of the Senate well before midnight.

After that, it was just a matter of watching the GOP wave grow. Of the ten competitive Senate seats (AK, AR, CO, GA, IA, KS, KY, LA, NH, and NC), the only “blue” win was for incumbent Jeanne Shaheen of New Hampshire, a friend to NADP. Democrats’ hopes of pick-ups in Kansas and Georgia fizzled, and although polls in North Carolina and Alaska favored the Democratic incumbents, Alaska Senator Mark Begich is considered likely to join NC Sen. Kay Hagan in the defeated column. (As of November 7, Begich was trailing GOP challenger Dan Sullivan by 8,000 votes. Begich points to the 50,000 outstanding ballots, and his come-from-behind victory in 2008 – he ultimately won by 1,000 votes after trailing by 3,000 votes on election night – as reasons for optimism.) Democratic defeats in AR, CO, and IA, while not unexpected, were by margins larger than predicted.

The biggest surprise of the evening hit close to home for NADP. Staunch supporter and oral health advocate Sen. Mark Warner (D-VA) was projected to win by nearly double digits. Instead, Warner declared victory with a 17,000 vote margin (less than one percentage point). Shortly before this article went to press, his Republican challenger Ed Gillespie conceded the race, precluding a re-count.

NADP members should also watch closely the run-off in LA. Democrat Sen. Mary Landrieu, an advocate for our industry, faces Cong. Cassidy again on December 6 as neither candidate achieved the threshold required for victory on election night.

Regardless of what happens in AK, VA, and LA, the Senate will be under Republican control in the coming year. Their current lead of 7 seats is widely expected to increase by 1-2 seats, bringing them close to the number held today by the Democrats.

Perhaps less dramatic, but no less impressive, were Republican gains in the House of Representatives. While continued Republican control of the House was a given, the gains outstripped expectations. The Republican majority has increased by 13 seats to 243, granting the largest majority, with 11 races still outstanding, in more than half a century.

Thus, on January 5, 2015, a unified Republican Congress will convene for the first time in 8 years. The day after the election, House Speaker John Boehner and Majority Leader-elect Mitch McConnell penned an op-ed in the WSJ laying out their united agenda for the new congress, highlighting their dramatically different priorities from the Democrats, and including “renewing [their] commitment to repeal ObamaCare….”

With virtually no chance of Democrats regaining control in 2016 (or for years, potentially decades, after), there is little harm and perhaps much to gain from House Speaker Boehner continuing to strike a sharp contrast with the President.

Reflecting the different Republican realities in the chambers, while vowing his commitment to repeal on the one hand, McConnell made public statements later the same day acknowledging the President’s veto pen.

Election night 2016 is surely already on Mitch McConnell’s mind as Republicans will be defending 24 Senate seats while Democrats defend less than half that number. The comfortable margin the GOP built up this week make it more difficult for the Democrats to reclaim the Senate in two years, but if McConnell would like to retain the title of Majority Leader in 2017, he must make good on his promise of a functional Senate. He will (and must, to serve key constituencies) deliver veto-bait bills to the President’s desk, but also must send bills that will be signed into law.

NADPac Report November 2014

Governor Seat Changed Party Lower House Changed Party

Both Chambers Changed Party Upper Chamber Changed Party

Insurance-related Ballot Measure Approved

* Election results undecided as of 11.5.14** WV State House changed party, and the Senate is now split 17:17

AK

AZAR

CA

CT

DE

DC

FL

HI

IL MD

MA

MI

MN

NV

NH

NJ

NYND

OH

OK

PA

RI

SC

SD

TN

TX

UTVA

WA

WV

WIWY

CO

AL GA

ID

INIA

KS KY

LA

ME

MS

MO

MT

NE

NM

NC

OR VT

*

**

**

Legislative races in 46 states were held November 4 and by all accounts, Republican gains in state legislative chambers and gubernatorial offices mirror those seen in the United States Congress. Republicans now have control of both chambers and the Governor’s office in 24 states (including Nebraska’s unicameral, nonpartisan legislature, which is effectively Republican controlled). Democrats have similar power in only six states.

• Governors: Voters in 36 states casted ballots for governors with Arkansas, Illinois, Maryland, Massachusetts and Pennsylvania seeing a change in party for the office. Election results are not final in Alaska, Connecticut and Vermont.

• Legislative Chambers: 46 states held elections for positions in legislative chambers. Partisan control changed hands in at least six states including Minnesota (House now R), Nevada (both chambers now R), New Hampshire (House now R), New Mexico (House now R), New York (Senate now R), West Virginia (House now R).

• Insurance Commissioners: Of the 11 insurance commissioners who are directly elected, three were put before voters for reelection in California, Georgia and Oklahoma. All 3 commissioners won reelection. In Kansas, Sandy Praeger (R) did not run for reelection and campaigned for democrat Dennis Anderson. Ken Selzer (R) was elected with 62 percent of the vote.

States and chambers not electing legislators this term include Louisiana, the Kansas Senate, the Minnesota Senate, Mississippi, New Jersey, the New Mexico Senate, the South Carolina Senate and Virginia. The following map highlights the states where the Insurance Commissioner, Governorship, Senate or Assembly has changed party hands:

In addition to legislative and gubernatorial elections, voters in South Dakota and California also considered ballot initiatives related to insurance.

California voters rejected Proposition 45 that would have required health

insurance rate changes to be approved by the Insurance Commissioner before taking effect. Opponents included insurers, providers and the state-based Exchange, who argued that passage could interfere with the Exchange’s role as an active purchaser that sets rating standards and could disrupt Exchange timelines for plan approval and offer. In South Dakota, voters approved an Any Willing Provider initiative—Measure 17—that requires all insurers to list as in-network any provider who is willing, qualified and who meets conditions for participation as established by the plan. According to the ballot initiative language, “The measure does not apply to all health insurers, nor to certain kinds of insurance and plans including those involving specified disease, indemnity, accident only, dental, vision, Medicare supplement, long-term care or disability income, and workers’ compensation.”

STATE ELECTION RESULTS

2014 Partisan Changes Among State Legislatures & Executive Offices

Following symbolic efforts to repeal Obamacare, we can expect more serious efforts to repeal components of the health law with bipartisan support: the individual and employer mandates, the medical device tax, and the “30-hour rule.” Congress is also likely to consider legislation to address the loss of pre-ACA health plans, and establish a new “copper” metal tier plan.

The two dozen plus new members in the Senate and House, along with a one party Congress and new agenda provides NADP new opportunities and challenges in the coming Congress. Although we’ve barely begun to feel relief from the deluge of this season’s political ads, NADPac would be well-served to initiate a slate of priority Members – House and Senate, Democrats and Republicans – for 2015 disbursements. Industry-sponsored events offer valuable opportunities for focused, thorough, and thoughtful discussion of the issues impacting NADP members.

Lisa Layman of Brown Rudnick represents NADP on Capitol Hill and has over two decades of experience in political and legislative affairs, and a comprehensive knowledge of health policy issues. As a senior policy advisor to several US Senators, Lisa has been involved in drafting, analyzing and negotiating legislation involving private health insurance, Medicare, Medicaid, prescription drugs, managed care, and health information technology.

For more information, please contactEvelyn F. Ireland, CAE • eireland@nadp.org

Executive Director & NADPac TreasurerNational Association of Dental Plans

P 972-458-6998 x10112700 Park Central Dr, Ste 400Dallas, TX 75251-1529NADPac

The following individuals and corporate PACs contributed funds to support NADPac efforts in 2014 and a July fundraising event held for Senator Warner (VA). NADPac appreciates the support of these contributors.

NADPac Contributors

• Ameritas PAC• Assurant PAC• Kirk Andrews, UnitedHealthcare• Timothy L. Brown, NADP• Cigna PAC• Mark Coyne, PPO USA• Daniel Croley, DDPA CA• Mike Davis, Dominion Dental

• Guardian PAC• Kris Hathaway, NADP• Suzanne Heckenlaible, Delta Dental of

Iowa• Evelyn Ireland, NADP• Lisa Layman, Brown Rudnick• Michael Lewan, Lewan Company• Theresa McConeghey, Principal

• MetLife PAC• Robin Muck, Premier Access Dental• Principal PAC• John Rice, Avesis • Chris Swanker, Guardian• United Concordia Dental (Highmark PAC)

Year 2014 NADPac Figures:Beginning cash balance 1/1/14: $15,630.13Closing cash balance 11/3/14: $22,680.13Contributions from individuals: $2,505.00Contributions from PACs: $17,000Disbursements to federal candidates: $12,000

Year 2013 NADPac Figures:Beginning cash balance 1/1/13: $12,180.13Closing cash balance 12/31/13: $15,630.13Contributions from individuals: $1,450Contributions from PACs: $12,000Disbursements to federal candidates: $10,000

FAST FACTS

NEW GOVERNORS COULD CHANGE STATE COURSE ON HEALTH CARE REFORM

How will party switching in some gubernatorial offices impact ongoing health care reform initiatives and Exchanges? Some like Maryland Governor-elect Larry Hogan (R) campaigned on a platform critical of their state’s direction in implementing the ACA.

Responding to an Exchange decision in the spring to continue state-based operations, Hogan released a statement, “Even with new technology, continuing to operate the Maryland Health Benefit Exchange is Martin O’Malley’s second worst business decision. Paying tens of millions of dollars for another state’s platform won’t cure the hopeless mismanagement…A better approach would be to immediately shut down the Maryland Exchange,” with the Federal system as a replacement.

Will Hogan work to change the state’s path on health care reform? Any legislation would still need to go through a Democrat-controlled Assembly. However, he may follow-up on his promise to further investigate the failed Exchange rollout.

By contrast, Illinois Governor-elect Bruce Rauner (R) has not voiced strong opposition to the state’s expansion of Medicaid. As quoted in the Chicago Tribune, while Rauner would not have passed Medicaid expansion, “it’s been done now and I’m not advocating a rollback. But what I am advocating and always have and always will is we’ve got to restructure Medicaid in Illinois. It is filled with waste and fraud.” Little is also known about how Rauner may react to a rumored effort in the Illinois legislature to take up previously stalled legislation creating a State-based Marketplace (SBM).

Switches in gubernatorial party in Pennsylvania with Tom Wolf (D) and Asa Hutchinson (R) in Arkansas could also impact the states’ ongoing approach to Medicaid Expansion. NADP will be watching all the states as health care implementation continues.