Democrats’ victories in the midterm elections could have a major impact on Americans’ healthcare, from how much people pay for health insurance and prescription drugs to what coverage is available to them, according to health policy experts and former White House advisers.
uncertain
coverage → have → experts
If the Democrats and President Donald Trump are willing to work together, that is.
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that → work → ?
With control of the House and Senate, Democrats will hold significant leverage to restore the enhanced Affordable Care Act subsidies, reverse cuts to Medicaid and push for changes they say would make healthcare more affordable.
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healthcare → hold → changes
They can also use their oversight powers to scrutinize the Trump administration’s health policies, including those led by Health Secretary Robert F. Kennedy Jr.
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They → use → those
The new Democratic majority will include three doctors who have been vocal in their criticism of the health secretary, including Senator-elect Annie Andrews of South Carolina, Senator-elect Abdul El-Sayed of Michigan, and Representative-elect Richard Pan of California.
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who → include → California
During her campaign, Andrews criticized Kennedy for overhauling the federal vaccine schedule and promoting medical disinformation, calling him an “archnemesis” to public health.
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Andrews → criticize → health
“We’ve seen a real transformation of the healthcare state over the last two years and it’s been immensely damaging,” said Miranda Yaver, an assistant professor of health policy and management at the University of Pittsburgh.
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Yaver → see → Pittsburgh
“We can absolutely expect to see a lot of oversight into these changes and unpacking what those harms are.”
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harms → expect → changes
But turning those policies into law won’t be easy.
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turning → turn → law
Any legislation would still need Trump’s signature, setting up a potential clash over the future of healthcare.
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legislation → need → healthcare
Ahead of Tuesday’s election, Trump said he’d brand himself “Mr. Veto” if Democrats took control of Congress.
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Democrats → say → Congress
On Wednesday, he said he’ll “probably” get along with the Democrats.
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he → say → Democrats
“The way I think about this is hunting versus farming,” said John Barkett, a former White House policy adviser under the Biden administration, where he covered drug pricing.
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he → think → pricing
Hunting, you go for a big kill.
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you → go → kill
If those pass, probably not going to happen [with Trump].
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those → pass → Trump
But can you sow seeds and prepare land for growth over time?
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you → sow → time
Here are five ways Democrats could take on healthcare.
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Democrats → take → healthcare
ACA subsidies
House Minority Leader Hakeem Jeffries has said restoring the expired enhanced ACA tax credits would be a primary objective for Democrats if they took control of Congress in 2027.
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they → say → 2027
When those federal subsidies expired at the end of last year, millions saw their monthly premium bills double or even triple — forcing about 3 million people to walk away from their coverage altogether.
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bills → expire → coverage
Others switched to cheaper plans that offered worse coverage.
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that → switch → coverage
In 2027, costs are expected to rise even more.
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costs → expect → 2027
ACA premiums are jumping by double digits for the second year in a row, and a mix of lower enrollment and rising healthcare costs is driving some major insurers to pull out of the market.
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insurers → jump → market
Larry Levitt, executive vice president for health policy at KFF, a nonpartisan health policy research group, said that if Democrats manage to negotiate a deal with Trump to restore the enhanced subsidies, the relief could be backdated to the beginning of 2027.
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relief → say → 2027
That means anyone who paid the higher premiums would get that money back as a refund.
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who → mean → refund
“That could both increase enrollment and provide cost relief to current ACA enrollees,” he said.
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he → increase → enrollees
Dr. Ezekiel Emanuel, a special adviser for health policy during the Obama administration, said he supports Democrats pursuing reimplementing ACA subsidies as long as they can find the money for it and they don’t lose sight of rising insurance costs for other Americans.
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they → say → Americans
“One of the dangers of big election victories is people get cocky and they overreach and they fail to deliver on what people actually care about,” he said.
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he → get → what
“Half of all Americans get their insurance through employer-sponsored insurance.”
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Half → get → insurance
Medicaid cuts
The Medicaid cuts under Trump’s “big, beautiful bill,” especially the Medicaid work requirements, are also expected to draw significant pushback from Democrats.
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cuts → expect → Democrats
The work requirements are expected to strip coverage from millions of people — not for lack of employment, but due to burdensome paperwork and other red tape.
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requirements → expect → paperwork
A number of states have already started implementing the requirements ahead of the national Jan. 1 deadline.
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number → start → deadline
Last week, a federal judge in Boston dealt a blow to the administration’s work rules, blocking a policy from the Centers for Medicare & Medicaid Services that would have forced “medically frail” patients and people with disabilities to prove they are too “significantly impaired” to adhere to the new work mandates.
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they → deal → mandates
The judge also granted states an additional six months to implement the more lenient version.
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judge → grant → version
Levitt said Trump is bound to veto any bills rolling back Medicaid cuts.
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Trump → say → cuts
“Then the game of chess between Democrats and Trump will begin to figure out what healthcare can actually get enacted,” Levitt said.
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Levitt → begin → Democrats
It’s also possible a number of states could finally expand Medicaid.
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number → ’ → Medicaid
Ten states have not adopted the full Medicaid expansion under the ACA.
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states → adopt → ACA
That includes Georgia, Texas and Wisconsin, which elected Democratic governors on Tuesday, alongside Kansas, where the race remains too close to call.
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race → include → Kansas
Yaver was skeptical, noting that Trump’s “big, beautiful bill” ended financial incentives that encouraged states to adopt the expansion.
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that → note → expansion
“I think we’re absolutely going to see efforts to increase Medicaid access,” she said.
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she → think → access
…and 26 more, not listed.
The Aporia
