Professional Point

The new year brings new faces and a shift in party control in both chambers of Congress. In planning our federal legislative agenda for 2007, we in the Practice Directorate anticipate greater likelihood that our issues, along with our perspective on the issues that are important to professional psychology, will earn consideration by congressional leaders as well as rank-and-file members. Of particular interest, two of our professional colleagues and friends of psychology-Reps. Brian Baird, PhD (D- Wash.), and Tim Murphy, PhD (R-Pa.)-easily won reelection to the House.

On the other hand, we don't expect wholesale changes in legislative policy. For one thing, while the Democrats gained control of the Senate, they remain short of the 60 party-line votes necessary to stop a filibuster, a mechanism often used to block contentious legislation. Further, the new Congress includes a number of Democrats, especially those who were elected from districts formerly represented by Republicans, whose policy views are considered conservative. Prominent political pundit Charlie Cook was quoted in the National Journal as saying, "House Democrats...seem to recognize it would be a horrible mistake to start playing 'Happy Days are Here Again,' while turning 90 degrees to their left."

In light of these overarching considerations, it would seem most productive to focus on achieving longstanding issues rather than advancing a new set of legislative priorities at the outset. One key development likely to work in psychology's favor is the change in congressional leadership. On the House side, former Speaker Hastert did not allow bills to move unless they had the support of a majority of the Republican House members. For example, the mental health parity bill-the Paul Wellstone Mental Health Equitable Treatment Act-had a majority of 230 co-sponsors during the last Congress, including 37 Republican members. Even so, the House leadership prevented the bill from moving through the committee process for consideration.

Speaker Nancy Pelosi (D-Calif.) has indicated that she does not intend to operate in the same manner as her predecessor. Bills will move forward if they have the support of a majority of members on the House committee with primary jurisdiction for a particular bill. Indeed, our government relations staff anticipates that the momentum on parity legislation will shift to the House in 2007, and that the bill will move there before the Senate takes action on it. It is significant that the incoming chairmen of the two House committees with jurisdiction over parity legislation are themselves strong advocates of full parity.

On other issues, we are less likely than before to be put in a defensive posture. Association health plans (AHPs), a central component of President Bush's health-reform agenda, offer a good example. AHPs are intended to enable small businesses to join together for the purpose of ensuring employees as a larger pool and, therefore, at less cost. Unfortunately, because they would dismantle dozens of state-level mental health protections, we have aggressively challenged these AHP bills in the House and Senate.

The House passed AHP legislation seven times over the past several years. That in turn required us to marshal considerable opposition by grassroots psychologists and other allies. Now many policy analysts and health care lobbyists consider AHP legislation to be off the agenda for the new Congress.

Another challenge that continues is working to reverse the steep cuts in Medicare reimbursement rates that apply to psychologists in 2007. Last fall, practitioners faced total Medicare cuts of 14 percent effective in January: 5 percent attributable to an automatic annual formula for payment adjustments; and another 9 percent that resulted from a "five-year review" of Medicare payment levels by the Centers for Medicare and Medicaid Services. During the lame duck session in December, we succeeded in stopping the 5 percent portion of the cutback. Although the remaining 9 percent cut is proving to be more difficult to turn back, we have developed key support in the House and the Senate and remain optimistic that we can convince the Congress to retroactively fix this problem when the new Congress convenes (see "Psychology helps stop 5 percent Medicare payment cut...").

The health-care system in this country continues to be badly in need of reform. The Nov. 13, 2006, issue of the Health Care Daily Report noted research that found 47 percent of voters said that health care was a deciding factor for them on election day. Yet, to paraphrase Charlie Cook, it would be mistake for us to start playing "Happy Days Are Here Again" until we see whether Congress will actually embrace this widespread concern and take significant steps to fix our broken health-care system.