The midterm elections last week changed how Congress will look next session, with potential implications for health policy.

The details:

Health care experts elected: Several House and Senate candidates leaned into their health backgrounds while campaigning on health issues, with some galvanized to run by opposition to Department of Health and Human Services (HHS) Secretary Kennedy. Newly elected members with health backgrounds include, among others: Annie Andrews, a pediatrician (SC-Senate); Michelle Berman, an emergency room nurse (WI-1); Richard Pan, a pediatrician and public health researcher (CA-6); Abdul El-Sayed, a doctor and former public health official (MI-Senate); Amish Shah, and emergency medicine doctor (AZ-1); and Kristina Knickerbocker, a nurse practitioner (OH-10).
Health care leaders leaving: At the same time, some departing lawmakers have played prominent roles in health policy. Sens. Cassidy, Marshall, and Collins lost reelection, leaving openings on the Senate Health, Education, Labor, and Pensions (HELP), Finance, and Appropriations Committees. Cassidy, a doctor, served as chair of the Senate HELP Committee. Marshall, also a doctor, chaired the Make America Health Again (MAHA) Caucus. Collins has been a prominent booster of federal support for research. Reps. Doggett and DeGette, both longtime members of the House Energy and Commerce (E&C) Committee, and Rep. Buchanan, chair of the Ways and Means health subcommittee, are also leaving. Rep. Greg Murphy, a surgeon, conceded his race. He prioritized defending doctors’ interests, was co-chair of the GOP Doctors Caucus, and was an ally of the American Medical Association.
Committee changes: Leaders of the committees that oversee health care will change, though committee appointments will not be finalized until next Congress. Sen. Sanders is set to become chair of the senate HELP Committee, with plans to expand health coverage. Sen. Paul, an ophthalmologist by training, plans to become ranking member and is likely to spar with Sanders. Sen. Wyden is seeking to lead the Senate Finance Committee and Rep. Neal the Ways and Means Committee, proposing to expand access to health care and strengthen social safety net programs. Rep. Pallone is seeking to retake the gavel of the E&C, with priorities including reversing cuts to Medicaid, addressing kids’ online safety, and investigating the gutting of health agencies. Rep. Castor could lead the E&C Health Subcommittee, with the current Democratic leader Rep. DeGette leaving Congress. Rep. DeLauro is expected to chair the House Appropriations Committee and said she would use the role to increase domestic investments in health care and other sectors. Sen. Murray is expected to chair the Senate Appropriations Committee, and Sen. Murkowski is expected to be ranking member. The three of them are likely to work to rein in the administration’s moves to increase executive power over spending. Rep. Robert Garcia is angling to lead the House Oversight Committee and has said he wants to pursue investigations into Kennedy’s conduct.
Health legislative agenda: Early agenda items for the majority next Congress include holding votes to reverse the Medicaid cuts, restore Affordable Care Act (ACA) subsidies, and restore National Institutes of Health (NIH) research funding. Several supporters of Medicare for All were elected and are taking control of committees, but there is likely to be disagreement over how far to go on larger health care changes. President Trump remains in the White House with veto power, and 60 Senate votes are required to overcome a filibuster for most legislation, likely limiting the legislation Congress can pass.
Health oversight agenda: The majority is also likely to use subpoena power to investigate administration health policies, including staff reductions and withholding funding from HHS agencies, possible industry interference, etc.

Why it’s important: Insurance access, particularly through Medicaid but also the ACA, is critical for access to addiction treatment, so changes the new Congress makes to these programs could have a major impact. Similarly, the new Congress could address diminished staff and funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), NIH, and other health agencies that has limited programs’ capacity to provide important substance use prevention, treatment, and research programs.