The ACR Agenda in D.C.: Where We Stand in Mid-April

Editor’s note: This blog by Dr. Worthing originally appeared on the ACR’s Advocacy Listserv.

Here’s a perspective on the current climate in which your government affairs team works. As you read this list of observations, imagine you’re a lawmaker and try to find where the ACR’s agenda fits into the current landscape:

1. Washington is highly politicized. Interparty rancor grew with the highly politicized SCOTUS [Supreme Court of the United States] confirmation and removal of the filibuster by Republicans. Also, intraparty conflict within the Republican party was stoked when moderates and Freedom Caucus members did not support the Ryan/Trump healthcare bill. (As you probably know, the bill failed; now, it’s a zombie—neither dead nor alive; more below.)
2. Institutions are weakening. Multiple global and domestic institutions are losing support, recognition, power or relevance. Take your pick: NATO, the Senate, SCOTUS, U.S. federal agencies, election campaigns. Leaders on both sides of the aisle are concerned about this.
3. People are being investigated. The Senate and FBI are investigating Russia and the Trump 2016 campaign regarding the presidential election. This creates work for all sides, possibly limiting the focus on other legislative and executive initiatives, possibly influencing Trump’s behavior and testing alliances in the balance of power with third parties (e.g., ISIS, Syria, Iran, Turkey).
4. Have you noticed any relevance to rheumatology yet? Moving on: the U.S. bombed Syria after Syrians were gassed in the ongoing war there. Civil war? Proxy war? Secretary of State Tillerson is in Russia asking [Russia] to stop supporting Syria’s dictator (see #3 above). He could use the support of NATO (see #2).
5. There isn’t a clear overarching White House agenda. After a flurry of executive orders and a failure to pass the healthcare bill, priorities are unclear. And with infighting between senior White House staff, there are no high-level interlocutors to convey policy.
6. U.S. government funding ends April 28. This will probably force some bipartisanship to renew a continuing resolution (CR) and/or a budget, while other activity stalls. The $17 trillion debt and White House proposals to raise military spending may pressure leaders to reduce domestic discretionary spending (research) and entitlement programs (healthcare). Aha! There’s the beginning of the ACR agenda.

My apologies if the point is heavy handed, but long story short, we rheumatology advocates can be forgiven for feeling like we’re a little low on the priority list nowadays. But rest assured, your team is hard at work. Also, lawmakers are continually campaigning and want to start a relationship with us. The relationships we’ve nurtured through RheumPAC and our commonsense and nonpartisan initiatives have never been more critical.