ontinuing its efforts to aggressively advance the interests of anesthesiology in an increasingly challenging political, legislative and regulatory environment, the ASA Political Action Committee (ASAPAC) worked with more than 180 candidates during the hotly contested 2006 elections. As part of the 2005-06 election cycle — a cycle marked by a significant realignment of the nation’s political landscape — ASAPAC provided direct campaign support to 169 candidates running for the 435 seats up for re-election in the U.S. House of Representatives, 14 candidates running for the 33 seats up for re-election in the U.S. Senate and five candidates running for state office.

In the House, ASAPAC was focused on supporting the re-election efforts of incumbent lawmakers who had worked to advance important anesthesiology-specific bills. Targeted candidates included Rep. Pete Sessions (R-TX-32nd), coauthor of legislation to fix the anesthesiology teaching payment; Rep. Todd Akin (R-MO-2nd) and Rep. Henry Cuellar (D-TX-28th), authors of legislation to permit anesthesiologists to receive Part A pass-through payments from small rural hospitals; and Rep. John Sullivan (R-OK-1st), the author of legislation to make unlawful the practice of some nonphysician providers to mislead patients and the public at-large regarding the provider’s education, skills and training. All were re-elected.

Among open seat candidates — candidates running for seats that had been vacated by an incumbent — ASAPAC worked with scores of local politically active anesthesiologists in support of the successful campaigns of a number of top-tier candidates. Prominent state legislators Gabrielle Giffords (D-AZ-8th) and Peter Roskam (R-IL-6th); former Nevada Secretary of State Dean Heller (R-NV-2nd); former Lt. Governor Mary Fallin (R-OK-5th); and former County Commissioner in Hillsborough County Kathy Castor (D-FL-11th) will all join the 110th Congress with the support of anesthesiologists.

ASAPAC also provided significant support toward the successful re-election of physician members of Congress, including Reps. Dave Weldon, M.D. (R-FL-15th), a longtime friend of anesthesiology; Tom Price, M.D. (R-GA-6th), the spouse of an anesthesiologist; Phil Gingrey, M.D. (R-GA-11th); Charles W. Boustany, M.D. (R-LA-7th); and Michael C. Burgess, M.D. (R-TX-26th). Two physician candidates backed by ASAPAC — incumbent Rep. Joe Schwarz (R-MI-7th) and open seat candidate Peter Beilenson, M.D. (D-MD-3rd) — were defeated in primary elections earlier in 2006.

Other ASAPAC-supported lawmakers whose campaigns failed included a number of key figures from the powerful House Ways and Means Committee, including Reps. Nancy L. Johnson (R-CT-5th), J.D. Hayworth (R-AZ-5th) and E. Clay Shaw (R-FL-22nd). Rep. Johnson, a senior member of the committee, served as Chairwoman of the Ways and Means Health Subcommittee and was a leader in efforts to address problems with the Medicare physician payment system. Rep. Hayworth, a member of Rep. Johnson’s subcommittee, had a long record of support for physicians and for anesthesiologists in particular, including supporting ASA efforts to boost Medicare anesthesia work values and to fix the Medicare anesthesiology teaching payment rule. Similarly, Rep. Shaw, another senior member of the committee, had an exemplary record on key ASA issues, having authored two significant pieces of legislation affecting the specialty, one to eliminate the Medicare Sustainable Growth Rate (SGR) physician update formula and replace it with an annual update based upon the rising costs of providing services, and a second (which garnered more than 80 cosponsors) to eliminate the Medicare teaching anesthesiologist 50-percent payment penalty. The loss of Reps. Shaw, Hayworth and Johnson combined with the retirement of Rep. Bill Thomas, Chairman of the Ways and Means Committee, will significantly alter the composition and function of the committee.

Other veteran legislators who had worked with ASA and ASAPAC and who lost re-election bids were Rep. John E. Sweeney (R-NY-20th) and Rep. Gil Gutknecht (R-MN-1st). Rep. Sweeney, who worked closely with the anesthesiologists at Albany Medical Center, was a supporter of legislation to fix the anesthesiology teaching rule and an early advocate of legislation to prohibit nonphysician providers from misrepresenting their education, skills and training to patients and the public at-large. Rep. Gutknecht, a longtime acquaintance of many anesthesiologists at the Mayo Clinic, ably supported the specialty throughout his entire congressional career.

ASAPAC was pleased to provide support to a number of senior Democrats who succeeded in their re-election efforts and are well positioned to benefit from the realignment in the House. Re-elected Rep. Fortney H. “Pete” Stark (R-CA-13th), a frequent speaker at the ASA Legislative Conference and the author of the Democrat version of the Medicare anesthesiology teaching rule reform bill, will re-assume his position as Chairman of the House Ways and Means Health Subcommittee — a post he lost in 1994 when the GOP “Contract With America” class was swept into office. A prolific lawmaker and leader on health care issues, Rep. Stark is expected to waste little time in aggressively pursuing the Democrat’s health agenda. Joining him in those efforts will be re-elected Rep. Charles B. Rangel (D-NY-15th), the incoming Chairman of the full Ways and Means Committee. Rep. Rangel, another frequent guest of the ASA’s Legislative Conference, has strong ties to physicians through his district’s robust academic medical community.

Also benefiting from the congressional realignment are re-elected ASAPAC-supported Reps. Frank Pallone (D-NJ-6th) and Steny H. Hoyer (D-MD-5th). Rep. Pallone, who has worked closely with east central New Jersey anesthesiologists for nearly 20 years, will assume the chairmanship of the Health Subcommittee of the House Energy and Commerce Committee, Congress’ other key health care committee. Rep. Hoyer recently prevailed in a highly publicized contest within the Democratic Caucus to win the title of House Democratic Leader, one of Congress’ highest leadership positions, second in authority only to Speaker of the House Nancy Pelosi (D-CA-8th).

Moving across the Capitol to the U.S. Senate, ASAPAC worked to direct maximum levels of support to candidates with strong records of support for ASA, anesthesiology and medicine. Sens. Mike DeWine (R-OH), a longtime supporter of the specialty and a recipient of the 2006 ASA Excellence in Government Award; George Allen (R-VA), a cosponsor of legislation to fix the Medicare anesthesiology teaching payment rule; and Jim Talent (R-MO), who during his career in the House and Senate has worked closely with Missouri anesthesiologists on many occasions, received the PAC’s maximum level of support in their unsuccessful re-election bids. Sens. Jon L. Kyl (R-AZ), lead Senator on fixing the flawed Medicare physician payment system; and Olympia J. Snowe (R-ME), a key member of the Senate Finance Committee, received the maximum level of support from ASAPAC along with the support of Arizona and Maine anesthesiologists, respectively, in their successful campaigns. Ben Cardin (D-MD), author of House legislation to scrap the SGR formula, also received the maximum level of support from ASAPAC in his successful high-profile campaign to win an open seat in Maryland.

Since 2002, ASAPAC has actively pursued a successful strategy of working with candidates seeking elected state office and providing political support to those candidates when such contributions are permitted by state law. Consistent with that strategy, this election cycle, the PAC made a maximum contribution to ASA Treasurer John M. Zerwas, M.D., in his successful bid to represent the 28th District of the Texas House of Representatives. With his win, Dr. Zerwas becomes the sixth anesthesiologist in elected state office. Retaining his spot on the list of elected anesthesiologists also is Maryland State Sen. Andy Harris, M.D. (R). ASAPAC provided support to Sen. Harris in a hard-fought campaign to retain his competitive seat.

Also at the state level, Nevada gubernatorial candidate Jim Gibbons (R) and Maine incumbent Governor John Baldacci (D) received support from ASAPAC along with the support of Nevada and Maine anesthesiologists, respectively, in their successful campaigns.

From the federal to the state level, ASAPAC, supported by active grassroots anesthesiologists, enjoyed success in the outcomes of many election contests. While a number of key supporters did not fare well in the nation’s political realignment, more than 90 percent of anesthesiology-supported candidates prevailed. With their success comes new opportunities for the specialty to work with new and veteran lawmakers alike to address the serious challenges faced by practicing anesthesiologists. The leadership and active physicians of ASA intend to take advantage of these opportunities created by 2006 elections to forcefully make the case for the well-being of the specialty in 2007.

Manuel E. Bonilla, M.S., works on federal legislative issues important to the membership. He is director of the ASA Political Action Committee.