A Recap of Key Developments in a Changing Political and Healthcare Landscape

National Health Service Corps and health center advocates—like the rest of the nation—have been carefully watching the U.S. midterm elections. Held in the midpoint of presidents’ four-year terms, midterms often bring fundamental shifts in Congressional power. All 435 seats in the House of Representatives and 35 Senate seats came up for a vote on November 8th—and healthcare, too, was on the ballot, as shifting Congressional control will seriously impact the Biden Administration’s ability to enact its policy agenda in all areas, including healthcare. Find a quick recap of what we know so far—and what it means for healthcare, health centers, and the National Health Service Corps—below.

Senate Seats

On November 13, 2022, Democrats retained control of the Senate, with 50 confirmed seats. This was a result of Senate Democrats narrowly winning in Arizona and Nevada, in addition to Democratic Senator-Elect John Fetterman flipping Pennsylvania’s previously Republican-held Senate seat. In Georgia, a December 6th run-off election will occur between incumbent Democrat Senator Raphael Warnock and Republican Herschel Walker, as neither won 50% of the vote. Even if Senator Warnock loses and Democrats only have 50 seats in the next Congress, Vice President Kamala Harris will continue to hold the tie-breaking vote. This means that for the next two years, Democrats will continue to control the process for confirming judges and executive branches. These judges may be important in determining future cases related to voting accessibility, LGBTQ rights and healthcare, and reproductive rights.

When it comes to President Biden’s administration appointments, over the previous two years, opposition from Senators such as Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) prevented the nominations of any appointee. If Democrats gain their 51st seat through the Georgia runoff election, it could be easier to approve nominees for positions such as the director for the National Institutes of Health without the support of every Democratic Senator.

The Senate Committee on Finance expects finalizing language for the bipartisan mental health package to become the focus of committee’s post-election “lame duck” session. (A “lame duck” session of Congress is one that takes place after the election for the next Congress has been held, but before the current Congress has reached the end of its constitutional term.) The legislation’s main concerns include integrating mental health services with primary care and standardizing Medicare reimbursements for mobile crisis response services.

Democratic leadership is also interested in passing another major spending bill, which could include more support and funding for health centers through Medicare expansion and enhanced childcare provisions removed from other recent proposed legislation.

House Seats

Every two years, all 435 House seats are on the ballot. The party that holds at least 218 seats controls the House Majority. At this moment, Republicans need just one more seat to gain control of the House. Many house seats are still undecided and remain too close to call. If House Republicans retake the majority as expected, the primary health agenda would be investigating the government’s pandemic response, the origin of Covid-19, addressing the opioid crisis through the reduction of fentanyl access, lowering healthcare costs, and increasing innovation among drugmakers. It is difficult to accurately predict Republicans’ full priorities, however, as the party ran without a comprehensive agenda. Stay tuned for updates as final results and races are called in the days ahead.

What Does This Mean for Health Centers and the NHSC? Fiscal Year 2023 Appropriations and More

As a reminder, on September 30, 2022, President Joe Biden signed into law a continuing resolution (CR) that prevented a government shutdown just hours before federal funding was set to expire. The CR extended current funding levels through December 16th, ensuring that the National Health Service Corps and all other key programs will continue to receive the same funding level as appropriated in Fiscal Year 2022 (FY22) and giving both chambers extra time to negotiate an FY23 omnibus spending bill.

A small group of Republicans have expressed that if they win the House majority coming out of the election, they will oppose any consolidated appropriations bill—also known as an omnibus bill—that occurs before the next Congress starts on January 3, 2023.

The good news is that regardless of who wins the majority in the House or Senate, the National Health Service Corps (NHSC), Nurse CorpsHealth Centers ProgramTeaching Health Centers (THC) Program all have strong bipartisan support. But, the outcome of the election will have a direct impact on total funding and the timeline for when funding is determined. If Republicans win the House majority, a smaller total funding omnibus bill will most likely pass Congress. As a smaller omnibus bill, however, it would be unlikely that provisions to extend mandatory funding for the NHSC beyond FY23 will get attached to an omnibus legislative package. There are many variables still at play in terms of what action steps lay ahead during the lame duck session – this makes staying informed and in contact with your members of congress about what’s important to your health center and the patients you serve more important than ever before.

Where Do We Go From Here?

Whatever the political outcome of the elections, your voice and advocacy have already made a powerful impact. Health centers played an important nonpartisan role in empowering their patients for civic engagement in this election—and we need to keep up the momentum and advocacy as we move forward to continue uplifting the voices of our communities and to protect and expand key health extender programs like the NHSC. If you haven’t already, invite your members of Congress to visit you at your health center. Let them see with their own eyes the incredible work you and your teams are doing to care for your communities and patients, and educate them on what’s at stake if they fail to take swift action to increase and extend funding for the NHSC, Health Center and Teaching Health Center program.

Keep up-to-date with the latest developments by joining our network as an advocate and watch for an upcoming white paper on the National Health Service Corps, action alerts, and more in the near future. Please contact us with any questions or if we can be of assistance in your own advocacy.