The news came shortly after 11:00 p.m. EST on Nov. 6: President Barack Obama had won Ohio and a second term in office.

The final electoral count tally gave Mr. Obama 332 Electoral College votes and Republican nominee Mitt Romney 206. The popular vote was much closer; with 99 percent of the ballots counted, Mr. Obama had about a 3.25 million vote lead nationwide (out of more than 120 million votes cast), giving him just over 50 percent of the popular vote.

2012 Electoral College

In his victory speech, Mr. Obama congratulated Mr. Romney and his running mate, Rep. Paul Ryan, on a hard-fought campaign while reiterating his commitment to achieving bipartisan solutions with the help of Congress.

In his response to Mr. Obama’s victory, John R. Tongue, MD, president of the American Association of Orthopaedic Surgeons (AAOS) acknowledged the positives that were part of the massive healthcare reform act, which even the president is now calling “Obamacare.”

“During his first term, the President and his administration fulfilled vital patient needs by improving access to health insurance coverage and preventive care, lowering prescription drug costs, and implementing consumer safeguards against insurance industry abuse,” said Dr. Tongue. He went on, however, to point out the deep-rooted challenges that remain, including the Sustainable Growth Rate (SGR) formula and the absence of medical liability reform, which are preventing musculoskeletal patients from enjoying the responsive healthcare system they deserve.

“The AAOS stands ready to work with the President and Congress to achieve these and other patient-centered reforms so that our nation can finally enjoy a healthcare system that meets the needs of patients and the physicians who care for them,” said Dr. Tongue.

The first challenge
Mr. Obama will have little time to enjoy his success and will have to work hard to fulfill his pledge for compromise and bipartisanship. Because Republicans maintained control of the House of Representatives, Mr. Obama’s first challenge will be to work with Speaker of the House John Boehner and his majority to prevent the country from falling off a fiscal cliff.

Among the issues that will need to be addressed are the impending sequestration cuts to vital federal programs, the looming 27.4 percent cut to physicians’ Medicare reimbursements mandated by the SGR formula, and the expiration of the Bush-era tax cuts, the 2 percent payroll tax cut, and unemployment benefits.

Rep. Boehner sounded conciliatory in remarks after the election, saying he would consider raising taxes “under the right conditions” and calling on the president to find “common ground” with Republicans. National Republican Congressional Committee Chairman Pete Sessions, however, pledged in a statement, “House Republicans will continue our work to restore fiscal sanity in Washington, revive America’s free enterprise system, and provide leadership that is worthy of the trust that Americans have once again placed in us.”

GOP controls a shifting House
Republicans maintained their House majority with a total of 233 seats to the Democrats’ 193 seats (as of this publication). Several races are still too close to call, including one in Louisiana that is headed for a run-off next month. Although Democrats gained a net of seven seats, they fell well short of the Democratic Congressional Campaign Committee’s “drive for 25” campaign to reclaim control of the chamber.

The Democrats enjoyed overwhelming success in the Northeast, where many candidates in toss-up races were helped by President Obama’s strong performance at the top of the ticket. New Hampshire’s two Republican incumbents were defeated by Democratic challengers, while in Massachusetts, beleaguered Democratic incumbent John Tierney was able to hold off his Republican challenger. Moderate Republicans also lost their bids in Connecticut and Rhode Island.

Republicans dominated House races in the South, picking up seats in North Carolina, South Carolina, Kentucky, and Arkansas, including some held by moderate Democrats and Blue Dog Coalition members. Blue Dog Democrats John Barrow of Georgia and Jim Matheson of Utah ran disciplined campaigns and were able to survive the toughest challenges of their political careers. The Orthopaedic Political Action Committee (PAC), as well as other specialty physician PACs, sponsored independent expenditure radio ads supporting Matheson.

In the Midwest, Democrats successfully gained four seats in Illinois. In redrawn districts that pitted two incumbents against each other, however, Republicans Jim Renacci of Ohio and Tom Latham of Iowa prevailed against their Democratic opponents.

Physician representation stable
Of the 19 physicians in the 112th Congress, one (Rep. Ron Paul, an obstetrician/gynecologist) retired and one (Rep. Nan Hayworth, an ophthalmologist) was defeated. This month, Republican Rep. Charles Boustany, a cardiothoracic surgeon, will face a run-off against Democratic Rep. Jeff Landry in Louisiana after both candidates failed to receive at least 50 percent of the vote.

Nevada’s Rep. Joe Heck, an osteopathic surgeon, and Michigan’s Dan Benishek, a general surgeon, hung on in close races to win reelection. In California, Raul Ruiz, MD, an emergency physician, defeated Mary Bono Mack, and Ami Bera, MD, an internist, is ahead by a razor-thin margin of 184 votes against his GOP opponent, incumbent Dan Lungren, in California’s 7th Congressional District. Rep. Lungren, however, had not conceded as this issue went to press.

If Drs. Boustany and Bera win, the number of physician members in the 113th Congress will remain at 19.

Democrats up two in Senate
In January, Democrats will control the Senate 53 to 45—a net gain of two seats from their current majority. Vermont’s Sen. Bernie Sanders and Maine’s Sen.-elect Angus King are expected to caucus with the Democrats, giving them a 10-seat edge over Republicans.

On election night, Senate Majority Leader Harry Reid honored Washington Sen. Patty Murray, chair of the Democratic Senatorial Campaign Committee for her efforts in defending the 21 Democratic-held seats this cycle, which many predicted would be difficult to retain.

Senate Democrats credit their success to key victories achieved by women such as Elizabeth Warren, who defeated Massachusetts Sen. Scott Brown; Missouri Sen. Claire McCaskill, who triumphed over controversial Rep. Todd Akin; and Rep. Tammy Baldwin, who defeated former Gov. Tommy Thompson for an open seat in Wisconsin. Rep. Baldwin becomes the first openly gay person elected to the upper chamber.

Other toss-up Senate races that went down to the final few days of campaigning also fell in Democrats’ favor. Connecticut’s Rep. Chris Murphy moved into the Senate, defeating former World Wrestling Entertainment CEO Linda McMahon. In Montana, a dead heat between Rep. Denny Rehberg and incumbent Sen. Jon Tester went to the wire, with Sen. Tester hanging on to win by more than 18,000 votes.

Indiana Rep. Joe Donnelly routed controversial Tea Party-backed candidate Richard Mourdock. Although Mr. Mourdock was favored throughout most of the summer, his controversial comments on abortion during a debate shifted momentum to Rep. Donnelly, despite Indiana’s right-leaning tilt at the top of the ticket.

Rep. Jeff Flake and incumbent Sen. Dean Heller were able to keep Arizona and Nevada in Republican control. Rep. Flake defeated former U.S. Surgeon General Richard Carmona to replace Arizona Sen. Jon Kyl, who is retiring. Sen. Heller won his first full term as senator over Rep. Shelley Berkley in Nevada. Orthopaedic surgeon John A. Barrasso, MD, cruised to victory in Wyoming, winning his second full term by a margin of 75.9 percent to 21.6 percent.

Orthopaedic PAC support
More than 5,160 AAOS fellows supported the Orthopaedic PAC in this election cycle, raising a combined (corporate and individual contributions) total of $3,708,271. The Orthopaedic PAC engaged in 252 congressional races and was successful in 21 of the 32 Senate races it was involved in this cycle.

The Orthopaedic PAC also dispersed $3,082,254—more than any other health professional PAC—to elect candidates who understand and support physician issues. It sponsored nine independent expenditure radio advertisements in support of Reps. Brett Guthrie, Nan Hayworth, Joe Heck, Tom Latham, Jim Matheson, Tom Price, and Denny Rehberg and Sens. Barrasso and Heller.

When the 113th Congress convenes in January 2013, members of the AAOS and the Orthopaedic PAC will continue to build and sustain meaningful relationships with legislators, sending a strong, clear message from orthopaedic surgeons to Capitol Hill.

Kristin Leighty is the Orthopaedic PAC manager; Madeleine Lovette is the communications specialist in the AAOS office of government relations.

Additional information
Special election edition of AAOS Advocacy NOW
Orthopaedic PAC
AAOS Advocacy in the News