Before the Storm
But President Bush created ONC in 2004 – a full five years before the Tea Party sprung to life, united in righteous rage at the $787 billion American Recovery and Reinvestment Act (ARRA), of which HITECH was a part.

Suddenly, thousands of people who didn't much care about President Bush's multi-trillion dollar deficits – his tax cuts, his off-book wars, his prescription drug entitlements – cared very, very deeply about President Obama's spending habits.

The past three years have seen the Tea Party caucus wield a power – whether or not it's commensurate with their actual numbers – that's very real. Simply put: they hate government spending – whatever benefits might come from those investments.

The Tea Party's attitudes are perhaps summed up best by Texas governor (and 2012 presidential also-ran) Rick Perry: "Washington's insatiable desire to spend our children's inheritance on failed stimulus plans and other misguided economic theories have given record debt and left us with far too many unemployed."

One year ago, Rep. Jim Jordan (R-Ohio) filed a bill, The Spending Reduction Act of 2011, that sought to lower federal spending by $2.5 trillion over the next 10 years. Among the host of federal programs targeted for elimination were "certain stimulus provisions" – including the Medicare and Medicaid EHR Incentive Programs set up under HITECH.

A Democratic president, veto pen at the ready, all but ensured that Jordan's bill would never become law. But as HIMSS’ Dave Roberts told me at the time, the concern was less the legislation itself than the uncertainty it sowed in a still-fledgling healthcare IT industry.

"We've heard from some CIOs, asking us, 'What is this? We hear the House is going to rescind our money,'" Roberts said then. "It adds to the confusion in the whole marketplace. And providers and hospitals who want to purchase this [technology] are wondering, 'Do I really want to start down this path?'

Roberts assured those people that the meaningful use program was something to count on. But he worried, back then, that "We're leading up to the 2012 elections. The Senate's majority is very reduced right now. And if this is a new way of thinking, that could be concerning."

One year later, "it's very quiet on that front," Roberts said. "We have seen no legislation – absolutely nothing at all – perceived as trying to do anything" related to defunding HITECH.

In fact, "I don't think we've heard in over a year from anybody really complaining about using federal funding to prime this area," he said. "Elected officials know how important the medical community is – and it is a good voting community. I think they see this as a wise use" of money.