Democrats seize Congress, and with it the fight over American healthcare

Democrats were projected to control at least 237 of the 435 House seats and at least 54 in the Senate as of Wednesday afternoon, according to The Associated Press, with Senate contests in Alaska and Mississippi still uncalled. Voters had named healthcare affordability a top concern in preelection surveys, and Democrats are now claiming a mandate to reverse the cuts President Trump and Republicans made to public health programs.

Trump, in a phone interview with Politico, said he had already spoken with Democratic leaders and that voters had delivered a message he needs to work with them. He added that he doesn't want to spend two years simply vetoing bills. That conciliatory tone will be tested fast — he can still block anything Congress sends him.

The early action item for the new Congress in 2027 is expected to be a legislative push to bring back the enhanced Obamacare subsidies that shrank premiums for millions before Congress let them lapse last year. Rep. Hakeem Jeffries of New York, the House Democratic leader widely expected to become speaker, told CNN the party should restore them for struggling families. Leslie Dach, who chairs the Democratic-aligned advocacy group Protect Our Care, said lawmakers would need to move within days of being sworn in, since enrollment for 2027 coverage ends Jan. 15 in most states. KFF researchers say benchmark ACA premiums are set to climb by an average of 13% for 2027.

Medicaid is the next battlefield. With Congress likely to pass another short-term funding bill in December, healthcare consultant Rodney Whitlock said the stage is set for a spring fight over Medicaid spending cuts and whether to repeal or delay them. Larry Levitt of KFF cautioned that Democrats can push an expansive healthcare agenda, including reversing Medicaid and ACA cuts, but that getting all of it done is impossible while Trump occupies the White House. Allison Orris, a partner at Manatt, warned clients before Election Day that undoing or even delaying the 2025 changes costs money and still requires the president's signature.

Control of the committees unlocks subpoena power, and Democrats have signaled they'll use it. They want to dig into Trump's confidential drug-pricing deals with pharmaceutical companies, which have never been made public, and into whether he benefited from stock moves when companies won Medicare price-negotiation exemptions under the 2025 GOP tax and spending law. They've also telegraphed probes into scientific decisions on flavored vape sales and White House promotion of the herbicide glyphosate, plus scrutiny of insurer preauthorization denials. A catch: the Justice Department, run by Trump, largely enforces subpoenas.