Joe Biden’s victory over Donald Trump to become the 46th President of the United States could make advocacy at the federal level more difficult, according to Gary M. Kirsh, MD, chair of political affairs for the Large Urology Group Practice Association (LUGPA) and President of The Urology Group in Cincinnati, Ohio.

Learning of Biden’s win on November 7 while participating in a session at LUGPA’s 2020 virtual annual meeting, Dr Kirsh said, “What it’s going to mean is CMS [Centers for Medicare and Medicaid Services] will flip under new leadership, and when I make this statement, I don’t make it in a partisan way, but I think it’s a fact, having been involved in policy and politics for as long as I have, that the Trump administration and CMS [were] the friendliest we’ve ever dealt with for independent practice. So we’re going to have more challenges on the regulatory side, but we’ve been there before.”

Dr Kirsh made the comments during a session updating attendees on the association’s political affairs and health policy activities and achievements.

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He observed that “the House has gotten tighter, the Senate is tighter than it was before, and it’s going to be very difficult to push major change through.”

He added, “We also don’t know who the committee chairs and ranking members are going to be because these are determined typically in December, after the election, by party leadership.”

However things shake out, he said, “that’s where we’re going to put a lot of our political focus.”

Deepak A. Kapoor, MD, chair of health policy for LUGPA and president of Integrated Medical Professionals in New York, who participated in the same session as Dr Kirsh, agreed that Biden’s victory is going to result in change in the leadership of CMS. He pointed out, however, the change will be influenced by the president’s cabinet, whose members must be approved by the Senate. If Biden nominates highly progressive candidates for cabinet positions, a Republican-led Senate probably will not rubber stamp the president’s choices. Even if Republicans are not in control of the Senate, “they’re going to make the process as unpleasant as possible for candidates who ideologically they don’t think they can work with,” given what transpired in the contentious Supreme Court confirmation hearings.