The Midterm Elections’ Effect on Public Health

November 15, 2022 | Carolyn Mullen, Devon Page

The 2022 midterm election proved to be one of the most fascinating in our modern times with the electorate weighing the balance of their decisions among three issues: democracy, reproductive rights, and economic security all against the backdrop of a waning global pandemic. After the dust settled in the end, it is clear our country remains deeply politically divided. That is evident in a split Congress with Republicans projected to have a slim margin of control in the House of Representatives and the Senate split with the democrats retaining their razor-thin majority.

However, when looking deeper into the specific districts an interesting theme emerged. It appears Americans prioritized electing incumbents, embraced bipartisan successes, and want to focus on the challenges they face every day. A question we must ask ourselves: are Americans starting to tire from the political fighting and do they want Congress to start solving problems?

In 2023, partisan legislation will not be signed into law because any bills moving through the Senate must garner the approval of 60 Senators. It is therefore within these rules, coupled with a narrow majority in the House opportunity abounds for Congress to achieve the goals that the American voters are signaling as important to them. Republicans and Democrats alike have consistently voiced commitment to expanding Health Savings Accounts and access to telehealth, reducing opioid-related deaths, and addressing the mental health crisis.

With many retirements in the Senate, many leadership positions of key committees will likely change. If longtime public health ally Senator Murray (D-WA) becomes chair of the powerful appropriations committee, Senator Sanders (D-VT) would be next in line to chair the Senate Health, Education, Labor and Pensions Committee (HELP) and his priorities in the previous congress focused on access to care issues. It is unclear if public health will be a central tenet of this chairmanship or if he indeed will prioritize education and labor, which may impact the speed at which Congress deliberates the reauthorization of the Pandemic and All-Hazards Preparedness Act.

In terms of their Republican counterparts, Senator Collins (R-ME) may become ranking member of the appropriations committee and her priorities would be focused on funding for biomedical research. Whoever becomes the ranking member of the HELP committee will seek to address the COVID-19 pandemic response.

With a projected Republican majority in the House, there will be a focus on conducting investigations into a litany of issues including an investigation into the origins of COVID-19 and addressing the ongoing substance use disorder crisis by increasing access to behavioral health services and cracking down on fentanyl. And the Healthy Futures task force, cochaired by Congressman Vern Buchanan (FL-16) and Congressman Brett Guthrie (KY-02), will continue look into topics such as pandemic preparedness, public health security, and the strategic national stockpile.

It is important to note that given the unexpected outcome of the midterm election, both parties are reassessing their top priorities for the new Congressional session. During the next few weeks Congress will hold a series of leadership elections for their respective parties. The government affairs team will be watching these developments closely because they will impact the overarching strategy for how Congress will govern for the next two years, which will undoubtedly impact ASTHO’s approach to advocacy.

Before jumping to the future however, the present Congress has a couple of months before the new folks get sworn in, and Democrats are already scrambling to do what they can. With the current continuing resolution expiring on Dec. 16—and a December 31 deadline for a FY23 National Defense Authorization Act—an appropriations deal and annual defense policy legislation are the chief concerns for members. For the other policy priorities, including new Ukraine Aid and an extension for the Child Tax Credit, it is anyone’s best guess.