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On election night, as my colleague Amanda Seitz and I watched returns pour in, it became obvious that Democrats’ decisive sweep of the U.S. House and Senate would reshape the direction of federal health policy — setting the stage for oversight investigations, a legislative push to reverse cuts to the Affordable Care Act and Medicaid, and a focus on lowering costs such as insurance premiums and drug prices.
To be sure, the party’s electoral success is likely to lead some Democrats to forge ahead with ambitious proposals, such as expanding Medicare, the federal insurance program for people age 65 and older, to cover all Americans.
Ultimately, though, job one for Democrats will likely be addressing the high cost of healthcare. Democrats view success on that front as critical to gaining an edge in the 2028 presidential election.
But any health policy changes won’t happen automatically.
Keep in mind that some of the Democrats’ big-ticket items — like undoing or delaying the Medicaid work requirements embedded in the One Big Beautiful Bill Act — were touted by Republicans during midterm campaigns as signature achievements. Reversing them now — or, similarly, reinstating the ACA’s enhanced subsidies — would require President Donald Trump’s buy-in, especially as he continues to wield the veto pen.
However, Trump has signaled he may be interested in brokering deals — drug pricing seems to be one area for potential agreement — as he seeks to cement his legacy and deflect fallout from investigations into his administration’s handling of the war against Iran, mass deportations, contract scandals, and other controversies.
Democrats, meanwhile, will need to carefully balance their policy moves against their desire to investigate a host of concerns surrounding the nation’s top health official, Robert F. Kennedy Jr., who has sought to dismantle U.S. vaccine recommendations and oversaw the gutting of staff at federal health agencies and the cutting of public health funding. Among other likely probe targets: the clandestine drug-pricing deals Trump made with pharmaceutical companies in return for relief from certain tariffs, and claims the president benefited from stock prices that rose when companies received exemptions from price negotiation in Medicare under the 2025 GOP tax and spending law.
All the while, Trump is likely to continue leaning heavily on executive actions to shape health policy from the White House.
Democrats’ retaking of Congress doesn’t change President Donald Trump’s control of the veto pen — making the new majority’s aspirations to reverse changes to Medicaid, the Affordable Care Act, and other safety net programs an uphill climb.
