Voters’ seemingly split decision in the 2022 midterm elections has big health policy implications. The Nov. 8 voting likely gave House Republicans a majority, while control of the Senate is undecided. If Republicans control even one part of the federal government, they’ll have at least some say on health policy.
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For one thing, President Joe Biden’s policy initiatives would face a wall of opposition in a Republican-majority House. That would give congressional Republicans the chance to push their own healthcare agenda. Here are some proposals such an agenda would likely include.
Competition
Republicans have promised to make “transparency, choice, and competition” the cornerstone of national health reform as private physician practices disappear and large health corporations continue to buy out competitors. Federal rules currently require physician practices to embrace electronic health records to qualify for higher reimbursement rates, a costly requirement for local practices, shifting focus from patients to paperwork. Congressional Republicans have said they hope to reverse these trends so that healthcare facilities can stay in business.
Telehealth
Telehealth’s increasing popularity has drawn bipartisan accolades. Right-leaning Americans for Prosperity and the left-leaning Progressive Policy Institute issued a joint report in 2021 demonstrating cost savings and life improvement from telehealth services. The Senate, up to this point, has failed to take up HR 4040, the Advancing Telehealth Beyond COVID-19 Act of 2021, which passed the House overwhelmingly.
Pharmaceuticals
The Inflation Reduction Act has significantly affected national health with its inclusion of a provision that puts price controls on some pharmaceuticals, increasing the cost of essential medication. Rep. Kevin Brady (TX), the former chairman of the House Ways and Means Committee and now its top Republican member, called the law’s drug provisions “dangerous.” Though Brady is retiring at the end of this term, repealing the bill will be a top priority among his Republican colleagues.
Yet these provisions have been popular among constituents, crossing party lines. In fact, former President Donald Trump’s administration issued an executive order initiating reimbursements to the lowest-price drug manufacturers in the hope of lowering prices paid for Medicare Part B. Trump also touted the success of out-of-pocket costs for insulin to a maximum of $35 a month for Medicare beneficiaries. However, if congressional Republicans can present a repeal of the Inflation Reduction Act, Biden would likely veto such action.
Transparency
Republican lawmakers have also pledged to begin a series of investigations into the Biden administration’s COVID-19 pandemic response, looking at the origins of the coronavirus and how dollars have been spent. “If you help me win, I promise to subpoena every last document of Dr. Fauci’s unprecedented cover-up,” said Sen. Rand Paul (R-KY) in an October campaign fundraising email.
Paul on Nov. 8 won reelection to the seat he’s held since 2011. Paul also recently vowed that as chairman of the Senate Health, Education, Labor, and Pensions Committee, the panel would investigate Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, over the federal government’s COVID-19 response. But lacking a committee gavel with Democrats in the majority, Paul and Republicans would have no power to issue subpoenas and otherwise pursue Fauci’s testimony.
Ballot initiatives
The 2010 Affordable Care Act gave states incentive to expand their Medicaid programs. Heading into the 2022 midterm elections, 12 states hadn’t done so. Now the number is 11, as South Dakota voters passed a ballot initiative to expand Medicaid, which will soon offer more health coverage to roughly 42,000 residents.
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Abortion was also on the ballot for five states: California, Kentucky, Michigan, Montana, and Vermont. All five states voted to uphold access to the procedure in one form or another.
A divided Congress
But what if Senate Republicans don’t find themselves victorious? A divided Congress brings legislative gridlock. On the other hand, the two parties may find common ground on affordability and telehealth. Still, the public will likely see an increase in executive orders from the president to advance top health policy priorities — without congressional oversight or at least a limited amount from House Republicans.
