HDM Blog colleagues Gary Baldwin and Vince Ciotti recently penned tongue-in-cheek predictions for 2011. So yeah, I'll jump on the bandwagon and take a more serious look at how Republican control of the U.S. House may affect health I.T. issues.

Full disclosure: I am a Democrat, raised by a very liberal mother and a conservative father who lost faith in the GOP when it nominated Goldwater for President and then tolerated Nixon's cover-ups. I easily could be a moderate Republican but that species is gone, as the party now somehow believes that ideological purity is healthy for a democracy. Off the soapbox and onto predictions:

1. House and Senate Republicans won't succeed in repealing the Affordable Care Act, but that doesn't mean they have to fund it. My bet is they will deny funds for a bunch of reform provisions, including creation of state health insurance exchanges. My hope is that the provision to develop "operating rules" to make the HIPAA financial/administrative transactions more uniform will be spared.

2. Many House GOP members, particularly Tea Partiers, will look at some $19 billion in borrowed money slated to pay financial incentives for meaningful use of electronic health records and decide it's money that doesn't have to be spent. But ideology won't be a match against angry constituents, particularly hospitals that offer lots of jobs in their communities, and the incentive funds will survive.

3. On the other hand, any remaining federal funding of comparative effectiveness research, which became reform opponents' method during the health reform debate by which the Obama administration would kill Grandma, is toast.

4. If an issue is tied to the Obama administration, it will be investigated in the House. Rep. Darrell Issa (R-Calif.) recently called President Obama "one of the most corrupt presidents in modern times." Most folks like this should not be taken seriously. But Issa is an exception as he's the new chair of the House Committee on Oversight and Government and promises continuous investigations of the administration's misdeeds. So, to counter the Institute of Medicine's study of the safety of EHRs, expect a "fair and balanced" investigation by Issa.

5. With the new House leaders looking for anything on which to damn the Obama administration, the "harm threshold" provision in the health care breach notification rule is low-hanging fruit. The provision enables an organization to determine on its own whether a breach is harmful enough to warrant notification. Expect the GOP to push for the threshold's removal if the administration doesn't remove it in a forthcoming final rule.


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