In the three weeks since the election many things have changed in Washington, but as a practical matter nothing has changed just yet. Donald Trump has been elected but President Obama is still in office and making decisions. Some cabinet officials have been chosen but they have yet to be confirmed by the Senate, much less getting to work. New members of the House and Senate have come to Washington for orientation, but they will not take office until January. The majorities are still held by Republicans but Senate Democrats can still filibuster most bills. Legislation, including the entire federal budget for fiscal year 2017, is being discussed on the Hill but Congress has not come back into session to vote on anything. Executive orders are in the planning stages for Day One of the Trump Administration, but Day One is eight weeks off. The transition is underway, but the new President, the new Congress, and the next Supreme Court are weeks and months away from governing.
Predictions about what the new Administration will do are almost entirely speculative, largely because the President-Elect of the United States, or PEOTUS, provided relatively little in the way of detailed policy proposals during the campaign, and he has shown a tendency to be open-minded about the ideas he has put forth. He has said next to nothing about immigration since the election but he has selected an attorney general with a strong record against amnesty for illegal immigrants. Mr. Trump has discussed a large infrastructure improvement program, a proposal that could not gain any traction with the Republican Congress in the last few years when Democrats proposed it. He has chosen a Secretary of Education who supports school choice and voucher programs. Additional cabinet appointments will tell us more about where he stands on the issues.
Repealing and replacing the Affordable Care Act is still a top priority according to transition officials. Repealing is fairly easy. Congress actually did so earlier this year through the reconciliation process, in which legislation concerning spending and revenues can be passed with only 51 votes. President Obama vetoed that legislation. Republicans will again have enough votes to defund and otherwise rescind the ACA and this time a veto is unlikely. However, actually taking away the ability to afford health insurance from 10 to 20 million people is something that supporters in Congress will have to consider carefully because there is no easy way to replace it. This time there are real life consequences, political consequences, and consequences for the healthcare and insurance industries that will have to be addressed. How this long-time priority for Mr. Trump and many Members of Congress plays out will be a crucial outcome of the election for many millions of people.
The effect of the elections on counseling is still very much in the speculative stage. Mr. Trump has said many times that the VA must do better for veterans so VA counselors may end up with more resources. The ability of many people to continue to pay for mental health care is uncertain. There is talk in Congress of making structural changes to Medicare. But nothing consequential is ever as simple in practice as it is in the soundbite. To govern is to choose, and many significant choices are going be made in coming weeks and months. ACA will be representing the interests of counselors whenever and wherever they are involved.