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The information contained in these slides is based on the information available as of the date of this live presentation and is subject to change. The content was presented for illustrative purposes and your information only. Applying this information to your situation requires careful consideration of facts, circumstances and timing of requirements. Consult your BKD advisor or legal counsel to apply to your unique situation and circumstances.

The Pulse on D.C TO RECEIVE CPE CREDIT

Individuals ➢. Participate in entire webinar . Answer polls when they are provided Groups ➢. Group leader is the person who registered & logged on to the webinar . Answer polls when they are provided . Complete group attendance form . Group leader sign bottom of form . Submit group attendance form to [email protected] within 24 hours of webinar If all eligibility requirements are met, each participant will be ➢emailed their CPE certificate within 15 business days of webinar Introduction

› Former Trial Court Judge

› Former Assistant Attorney General

› Former Chief of Staff & Counsel to a U.S. Congressman

Travis Lucas › Served in senior-level staff roles within agencies and the U.S. Congress

› Veteran of many political campaigns

› Has worked for Democrats and Republicans DISCLAIMER Information in this presentation is as of October 10 and is presented ➢by professionals for your information only & is not to be considered as legal and/or accounting advice. Applying specific information to your situation requires careful ➢consideration of facts & circumstances. Consult your BKD advisor or legal counsel before acting on any ➢matters covered. TM ➢Stay tuned for further developments through BKD Thoughtware . Who’s Likely to Win in November? The White House ➢› 270 electoral votes needed › Biden (safe, likely, lean) › Trump (safe, likely, lean) U.S. Senate ➢› If Biden wins, the Senate could possibly flip to the Democrats. › Current Senate composition is: 53 Rs and 47 Ds › Senators who are on the ropes: › TOSS-UPS › LEANINGS U.S. House ➢› The House will stay Democratic. › Current House composition is: 232 Ds — 197 Rs — 1 Libertarian — 5 Vacancies Congressional Lame-Duck Session November - December 2020 ➢The Continuing Resolution ends December 11. › Congress could: (1) fully fund FY2021, or (2) fund through 2021. › Congress will attach extenders: › Delays: DSH cuts › Adds: Community Health Centers, National Health Service Corps and the Teaching Health Center Graduate Medical Education Program; Reimbursement for Rural Providers; Money Follows the Person demonstration program; Medicaid Community Mental Health Services demonstration program. ➢What Congress ends up doing depends on how the elections turn out. Trump Administration 2.0 What to Expect The Composition of Washington, DC: ➢› If Trump wins, the Senate could possibly be in the hands of the Republicans. The House will stay in the hands of the Democrats. Expect to see more of the same policies you saw during the ➢first Trump term: executive orders (that are challenged in the courts); HHS rule-making (e.g. MFAR, 340B, etc.); a possible divided Congress only agreeing to “big ticket” items” like drug costs, etc. Biden Administration What to Expect - Generally CONGRESSIONAL BIDEN WHITE BIDEN HHS ACTION HOUSE ACTION ACTION The Composition of ➢Washington, DC: › If Biden wins, the Senate might Senate Cloture possibly be in the hands of the Rule? Democrats. The House will stay Aggressive use Aggressive in the hands of the Democrats. of executive agency rule- Aggressive orders making healthcare policy-making overall Biden Administration What to Expect - Specifically Protect and Bolster the ACA

Enact a public option like Medicare.

Increasing the value of tax credits to lower premiums and extend coverage to more working .

Expand coverage to low-income Americans.

End surprise billing.

End healthcare system consolidation.

Enact drug pricing reform. U.S. Congress What to Expect in 2020 and Beyond

If Trump wins, the Senate probably holds Republican ➢and the House will hold Democratic. There would then be a possible divided Congress only agreeing to “big ticket” items like drug costs, etc. If Biden wins, the Senate could possibly flip Democratic ➢and the House will hold Democratic. ➢Senate Democrats might scale back the Cloture Rule? U.S. Congress Democratic Healthcare Policies ➢Look at the Heroes Act ➢Look at Biden Campaign Healthcare Policy Agenda ➢Look at the Progressive Healthcare Policy Agenda U.S. Congress Other Possible Democratic Policies Affecting Healthcare Policy If Biden defeats Trump, and if the Democrats win control of the Senate and maintain control of the House, statehood for the District of Columbia and for Puerto Rico is a “talked-about” possibility. ➢On June 26, 2020, the House voted 232-180 to establish Washington, D.C. as the . A for Puerto Rico statehood will be held in Puerto Rico on November 3, 2020. If the ➢referendum favors statehood, and if Puerto Rico submits a petition for statehood, and if Biden beats Trump, and if the Democrats win control of the Senate, then there is a chance that the House and Senate will pass a resolution authorizing statehood. Statehood will result in four new senators, two each for DC and for Puerto Rico. Three or perhaps ➢even all four will likely be Democrats. Statehood will result in DC receiving one seat in the House and Puerto Rico receiving four seats. ➢The size of the House likely would remain at 435. Therefore, five states could each receive one less House seat in the 2020 : , , , , and . U.S. Congress Other Possible Democratic Policies Affecting Healthcare Policy JUSTICES

JUSTICES JUSTICES

U.S. SUPREME COURT How to Engage in 2020 and Beyond

How to Engage During COVID-19 Pandemic: ➢› People might not feel safe to meet in person until there is a safe and reliable vaccine that has been deployed to many (spring or summer of 2020?) › Few staff and officials are meeting in person, but they have been engaging in other ways: › through long-standing, personal relationships. › through Zoom (but this will wane as things get busier). Contact Information

1101 Avenue, ➢NW, Suite 300 Washington, DC 20004 ➢[email protected] ➢202-756-1226 Travis Lucas

CONTINUING PROFESSIONAL EDUCATION (CPE) CREDIT

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The information contained in these slides is presented by professionals for your information only & is not to be considered as legal advice. Applying specific information to your situation requires careful consideration of facts & circumstances. Consult your BKD advisor or legal counsel before acting on any matters covered.