The U.S. Elections: An Analysis of Health Policy Impacts & Advocacy to Come

U.S. Election Analysis: Topline Results from the Election

Presidency: Former President Donald Trump won re-election, securing key battleground states like Wisconsin, Pennsylvania, Georgia, and North Carolina, surpassing the necessary 270 Electoral College votes.

Senate Races: Republicans have gained control of the Senate, flipping seats in Ohio, Montana, and West Virginia, with additional close races still being counted. Currently, Republicans hold a 52-seat majority, potentially increasing with final tallies from remaining states.

House Races: Control of the House remains unknown with numerous races still too close to call, particularly in states like California and Arizona. However, as of Thursday morning, momentum has shifted in favor of the GOP retaining control of the House.

Potential Health Policy Agenda for a GOP “Trifecta” Controlling the Presidency, Senate, & House

If Republicans secure both chambers of Congress along with the White House, they could leverage the reconciliation process to advance partisan health policy initiatives. Their likely priorities could include:

• Allowing Affordable Care Act (ACA) subsidies to expire at the end of 2025.
• Possible cuts and reforms to Medicaid, such as introducing work requirements or converting some funding to block grants.
• Increased scrutiny on public health policies, especially around vaccinations, influenced by figures like Robert F. Kennedy, Jr., potentially impacting established health science policies and regulatory practices.
• Restricting federal funding for abortion and possibly curbing access to abortion medications.

Legislative Outlook for ACU and Our Members

To continue to fulfill our mission and help support underserved communities, ACU is closely monitoring these developments and is planning a variety of policy and advocacy initiatives. These include but are not limited to:

1. Preparing for a Year-End Fiscal Year 2025 (FY25) Spending Package: The future of a year-end FY25 spending package is still uncertain, but a successful passage is likely. The current continuing resolution includes discretionary NHSC funding that expires on Dec. 20, while mandatory NHSC funding expires on Dec. 31. House Republicans are awaiting guidance from the incoming president on handling this issue. Trump has two main options:
   • Full-Year Funding: He could advocate for a full-year funding package during the lame-duck session to allow Republicans to focus on his agenda in the first 100 days without the distraction of funding debates. This approach would mirror 2017, where delays pushed spending bills until May.
   • Partial-Year Funding: Alternatively, Trump might prefer to influence FY2025 spending, potentially aiming to cut or redirect funds for some agencies. This would necessitate a short-term continuing resolution.
2. Sending Congress a NHSC & THCGME Stakeholder Letter (November 14): ACU will send a stakeholder letter to Congressional leadership advocating for greater funding and support for the National Health Service Corps (NHSC) and Teaching Health Centers Graduate Medical Education (THCGME) programs prior to when current funding expires in December. We invite local, state, and national organizations to join us in signing on to the letter by Wednesday, Nov. 13.

3. Calls to Action for December NHSC Funding Expiration: With NHSC funding set to expire at the end of 2024, ACU will launch calls to action to our network to galvanize support for renewing this vital program. Please watch your inboxes and mobilize in support of the Corps! Learn why the NHSC matters and how it supports a stronger workforce in our newly updated White Paper.

4. Taking a Look at What a Reduced NHSC & Lowered Health Professional Shortage Area (HPSAs) Scores Mean for Health Centers: ACU will publish a post in our Allying for Health Access blog later this month addressing the decreased impact of the NHSC due to lower HPSA scores. We invite members to share stories highlighting these challenges.

5. Reaching Out to Freshmen Members of the 119th Congress: ACU will develop a list of new members of Congress, monitor committee assignments, and engage with Congressional staff of incoming members early in 2025 to emphasize the importance of our work and the NHSC’s role in healthcare for underserved communities.

6. Updating Our Legislative Priorities for the 119th Congress: Once Congressional committee assignments are finalized, we will update our legislative priorities and advocacy strategies, focusing on advancing previously stalled bills that are still viable in the 119th Congress.

7. Releasing NHSC Funding Letters to Build Support in Fiscal Year (FY26) Appropriations: ACU will strive to engage congressional champions early, seeking co-sponsors for NHSC funding legislation. Efforts will be coordinated with:

• Senate: Martin Heinrich’s (D-NM) and Lisa Blunt Rochester’s (D-DE) Office for NHSC funding.
• Senate: Jon Ossoff’s and Lisa Blunt Rochester’s Office for NHSC and Nurse Corps funding.
• House: Nanette Barragán (D-CA)’s Office for NHSC funding.

8. Seeking a New House Congressional Champion: ACU will seek a new House champion for the Energy and Commerce’s Health Subcommittee, as Blunt Rochester has been elected to the Senate.

9. Preparing for Important Post-Election Dates:

• November 12: Congress returns for lame duck session.
• November 13: GOP leadership elections in both House and Senate (Elections for Senate Democrats TBD).
• November 19: Expected leadership elections for House Democrats.
• December 20: Current continuing resolution expires, which includes discretionary NHSC funding.
• December 31: Mandatory NHSC funding expires, comprising approximately 70% of the NHSC budget.
• January 3: Election of Speaker.

These actions aim to strengthen ACU’s advocacy and legislative efforts, ensuring critical support for clinicians and healthcare access for underserved communities despite potential challenges in the new political landscape. Please contact us if you have any questions or if we can offer guidance in the meantime regarding your own policy and advocacy initiatives.

Jordan Marshall, Your ACU Advocacy Contact

Jordan Marshall is leading ACU’s grassroots advocacy to secure long-term funding for the National Health Service Corps (NHSC). Contact Jordan with any questions regarding policy analysis or if ACU can be of assistance with your own organizational or individual advocacy.