Biden victory and Republican Senate could lead to stalemate over health concerns

Update: This story was updated on November 4 at 4:40 p.m. ET to add more details on the state vote count.

Former Vice President Joe Biden appeared to be getting closer to the 270 electoral votes needed to win the presidency on Wednesday afternoon, but at the same time it was becoming clearer that Democrats would not take back the Senate majority they lost in 2014 If this is confirmed, it could well be a prescription for healthcare congestion.

Without a Democratic majority in the Senate, Biden as president likely couldn’t push forward many of his top health agenda items – including lowering the age of insurance eligibility – sickness at age 60, the expansion of financial assistance for health insurance under the Affordable Care Act and the creation of an optional “government health plan.”

However, a defeat of President Donald Trump would almost certainly halt his administration’s efforts to further erode the effectiveness of ACA and efforts to further transform the Medicaid program in favor of low-income people. back to states.

Even if Biden wins, it’s not the outcome Democrats hoped for – and, to some extent, expected, based on pre-election polls. Andy Slavitt, who headed the Centers for Medicare & Medicaid Services under the Obama administration, noted the frustration in a tweet Wednesday. “A big disappointment is that many were hoping for a meaningful repudiation of Trump and his indifference to human life, human suffering, corruption, and his goal of getting rid of the ACA. No matter the final total, it will be difficult to make that claim, ”said Slavitt.

It remains to be seen how much of a Republican-led Senate will be willing to provide additional relief to individuals, businesses and states hard hit by the coronavirus outbreak, and whether they will participate in previously bipartisan efforts to reduce the burden. “Surprise” off-network your medical bills and control the prices of prescription drugs.

Admittedly, nothing is final, as several key states, including Pennsylvania, still have thousands of postal and advance votes. But by mid-afternoon, the media predicted that Biden would have won 253 electoral votes, while Trump had 214. Unofficial reports also showed Biden leading in several states, including Arizona and Nevada, and close to the president in Georgia, where the first ballots were still being counted.

Biden was quick to note that nothing is final in the brief remarks he made on Wednesday afternoon. “I am not here to declare that we have won,” he said, “but I am here to declare that when the tally is over we believe we will be the winners.”

Although Democrats have invested tens of millions of dollars in races to defeat vulnerable Republican senators this year, most incumbents – including Senators Susan Collins (Maine), Steve Daines (Montana), Joni Ernst (Iowa) and Lindsey Graham (South Carolina) – won their battles. Several races are still too close to be announced.

But who controls Washington, DC, is only part of the impact of elections on health policy. Several key health issues were on the ballot both directly and indirectly in many states. Here are just a few:


In Colorado, a measure that would have banned abortions after 22 weeks of pregnancy – except to save the life of the pregnant person – failed, according to the Associated Press. Colorado is one of seven states that do not ban abortions at some point in pregnancy. It is also home to one of the few clinics in the country that perform third trimester abortions, often for serious medical complications. The clinic draws patients from all over the country, so residents of other states would have been affected if the Colorado Amendment had passed.

In Louisiana, however, voters easily approved an amendment to the state’s constitution to say that nothing in the document protects the right to abortion or requires its funding. This would make it easier for the state to ban abortion if the Supreme Court overturns Roe vs. Wade, which makes state abortion bans unconstitutional.


The fate of the Medicaid program, for low-income people, was not directly on the ballot anywhere in this election. (Voters approved the expansion of the program by Missouri and Oklahoma earlier this year.) But the program will be affected not only by who controls the presidency and Congress, but also by who controls legislatures in states that have not extended the program under the Affordable Care Act. North Carolina is a key state where a change in majority in the legislature could have reversed the trend of expansion, but Republicans have retained their majority.

Drug Policy

In six states, voters decided on the legality of marijuana in one form or another. Montana, Arizona and New Jersey chose to join the 11 states that allow recreational drug use. Voters in Mississippi agreed to legalize medical marijuana, and South Dakota approved legalization of recreational and medical pot.

Magic mushrooms were on two ballots. A measure in Oregon allowing the use of psilocybin-producing mushrooms for medicinal purposes has been passed, as has a proposal from the District of Columbia to decriminalize hallucinogenic mushrooms.

Another ballot question was also approved in Oregon to decriminalize possession of small amounts of hard drugs, including heroin, cocaine and methamphetamine, and mandate the establishment of drug recovery centers, using part of the tax revenue from marijuana sales to establish these centers.


As usual, California voters were faced with a long list of health-related voting measures.

For the second time in two years, the state’s profitable kidney dialysis industry was challenged at the polls. A union sponsored initiative would have required dialysis companies to employ a doctor in each clinic and submit infection reports to the state. But the industry spent $ 105 million against the measure. He failed, according to unofficial feedback posted by state.

Voters were also asked to decide, again, whether they should fund stem cell research through the California Institute for Regenerative Medicine via Proposition 14. Voters first approved the agency’s funding in 2004, and since then billions have been spent with little remedy for it. The measure has passed.

California has been at the forefront of the fight against the so-called odd-job economy, and this year’s poll included a proposal pushed by ridesharing companies like Uber and Lyft this would allow them to continue to treat drivers as independent contractors rather than as employees. Under Proposition 22, companies would not have to provide direct health benefits to drivers, but would have to give those who qualify an allowance that they could use towards a health insurance premium purchased on the market. state individual, Covered California. The measure was approved.

Finally, Golden State voters were asked if they should impose higher property taxes on commercial property owners with land and real estate valued at $ 3 million or more, which could help generate new revenue for economically struggling cities and counties hit hard by COVID-19, as well as ” Kindergarten to Grade 12 community schools and colleges. Community clinics, California nurses and Planned Parenthood have embarked on the thorny political battle over Proposition 15 – targeting powerful business groups – to generate revenue to help rebuild the public health system underfunded from California. The measure appeared to have failed in a close vote.

California Democrats, who control all elected offices statewide and hold a qualified majority in the legislature, have positioned themselves for a Biden victory, and some were already preparing ambitious health care legislation for the year next. If Biden wins, they said, they planned to crack down on hospital consolidation and end surprise emergency room bills, and some were quietly discussing liberal initiatives such as pursuing a health care system in single payer and the extension of Medicaid to cover more unauthorized immigrants.

JoNel Aleccia, Rachel Bluth, Angela Hart, Matt Volz and Samantha Young contributed to this story.

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California Elections Medicaid States Health law

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