Predictability and uncertainty in 2015

As the new Congress “heats up,” there are two contrary aspects of the Washington political scene, each competing for attention as the central narrative of 2015.On the one hand, the uncertainty is incredible. The key players are almost the same as in the past Congress, but the relationships are completely different. The new Republican leadership in the Senate will, in turn, affect House-Senate politics and then set up a more contentious dynamic relative to the President.How will that work out? Despite what some talking heads would have you believe: no one knows. It may lead to even greater frustration with the pace of law-making. Or, faced with mutually assured destruction in the public’s eyes, Republicans and the White House may find ground to compromise and become more productive than the last Congress.On the other hand, the predictability is also incredible. We know there will be votes on various aspects of health care reform. Those votes will be numerous and controversial, probably leading to Presidential vetoes.More to the point, we know that there are a series of fiscal cliffs (discussed here) that are spaced through the year and that will force Congress to address its own ideologically driven conflict between revenue increases and entitlement savings, with appropriated funding at risk for cuts, as well. What makes the fiscal cliffs different from health reform is that the President may have to sign some bills he opposes in order not to take the blame.In choosing between the narrative of uncertainty and the narrative of predictability in Congress, how is FDA affected? Frankly, we don’t know. We can envision the emergence of new champions who may be freer to advocate for increased FDA funding. But we can also foresee the possibility that Congressional players will be locked into the roles they’ve played for several years, where it has been hard to gain extra monies for any agency not at risk of total program failure.What seems most important is to keep focusing on the last message we delivered in 2014: that while macro-budgetary struggles are likely to grab headlines, the micro-budget of FDA is still very important. We concluded:

it is predictable that there will be a thaw -- perhaps 10 seconds long, maybe 10 weeks long -- when each agency will be judged for FY 16 funding. When that brief momentary thaw comes, the Alliance will be ready -- having already met with appropriations, budget, and leadership staff. We know that no federal agency can sell itself. Others must say: “FDA serves the American people.” With your help, we will be doing that.

In sum, FDA faces predictability in the process, but uncertainty in the outcome.Note: This week’s Analysis and Commentary was written by Steven Grossman, the deputy executive director of the Alliance for a Stronger FDA.