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With Democrats securing the majoritiesi in both the House and Senate, healthcare executives can expect a more assertive congressional agenda, increased oversight efforts, and continued legislative gridlock as Democrats and a Republican White House clash on key issues.
Five key takeaways post 2026 midterms
- Healthcare organizations will likely face greater scrutiny over costs, coverage and business impact.
Democrats are likely to use congressional hearings, investigations and proposed legislation to focus on healthcare affordability and industry practices, while the White House pursues its own cost-cutting agenda. - Democrats will have more power to shape healthcare policy, but major reforms will remain difficult to pass.
Democrats can advance healthcare legislation through both chambers, but Senate rules and President Trump's veto power will limit what can become law. - Healthcare policy changes could continue even without new laws from Congress.
The White House could increasingly rely on federal agencies, regulations and trade policies to advance its agenda without congressional action. - Republicans have a limited window to advance their remaining priorities.
Before Democrats take control of Congress in January, the lame duck window could provide an opportunity to address the debt ceiling and other republican priorities. - Pressure to lower healthcare costs will continue, regardless of political gridlock.
Affordability and access will remain major concerns for consumers, shaping industry decisions and the healthcare policy debate heading into 2028.
What healthcare executives can expect
With Democrats taking control of both chambers of the 120th Congress, healthcare affordability will take center stage in Washington. Expect more congressional hearings, investigations, and policy proposals focused on healthcare costs, expanding coverage, vertical integration, and industry practices. Democrats will also have a stronger platform to advance their healthcare priorities and build the components of a broader affordability package heading into the 2028 electionsii.
Democratic control gives healthcare legislation a clearer path through Congress, but enactment will remain challenging. With President Trump retaining veto authority, Senate procedural hurdles and narrow majorities limiting the prospects for major reform, targeted bipartisan legislation is most likely to move. Look for action on cybersecurity, AI, price transparency, modernizing drug development and prior authorization processes. Regardless of congressional gridlock, continued regulatory implementation will shape near-term business and compliance requirements.
Congressional control also shifts the balance of power between the White House and Capitol Hill. Democratic leadership brings more aggressive oversight and potential impeachment proceedings, while Senate control constrains the administration’s ability to confirm nominees, including a potential Supreme Court justice. In the lame duck, the outgoing Republican Congress will face pressure to advance outstanding fiscal and legislative priorities before its leverage diminishes. Government funding, the debt ceiling and a potential year-end package could create openings to address Republican priorities and advance targeted healthcare measures. Failure to resolve major fiscal issues could set the stage for more contentious negotiations between a Democratic Congress and a Republican White House in 2027.
Even where legislation stalls, don’t dismiss the headlines. Democratic hearings, investigations and proposed bills offer insight into the policies taking shape for 2028, while growing pressure around affordability continues to push the healthcare market toward consumer expectations. Executives who look beyond near-term political conflict, plan for multiple policy scenarios and adapt to evolving consumer demands will be better positioned for potential healthcare reform after 2028.
Subsector analysis
Payer no regret actions
Proactively manage reputational risk and strengthen consumer trust as congressional hearings and oversight increase public scrutiny on industry practices such as affordability, plan quality, antitrust, and coverage.
Plan for continued Medicare Advantage funding pressures and potential changes aimed at leveling the playing field
Strengthen price transparency and consumer engagement to help address growing expectations around affordability and access.
Scenario-plan for potential coverage reforms involving Medicaid, ACA subsidies and broader affordability proposals heading into 2028iii,iv.
Invest in operational efficiency and compliance to manage costs and prepare for evolving regulatory requirements.
Provider no regret actions
Assess exposure to congressional oversight of healthcare consolidation, price transparency, and other industry practices.
Stress-test financial models against potential coverage and reimbursement changes.
Strengthen price transparency and affordability strategies to prepare for continued consumer pressure and potential reforms.
Accelerate operational efficiencies to help address continued financial and workforce pressures.
Pharmaceutical & Life Sciences no regret actions
Scenario-plan for 2028 when pricing & affordability will be back on the table, including the future of MFN policy, 340B reforms, and evolving federal drug pricing policies heading into 2028.
Proactively manage reputational risk and strengthen consumer trust as congressional hearings and oversight continue public scrutiny of industry practices.
Strengthen evidence of clinical and economic value to support market access and reimbursement.
Monitor bipartisan opportunities to modernize drug development and regulatory pathways.
Medtech no regret actions
Assess where congressional scrutiny of healthcare costs may overlap with business operations.
Demonstrate clinical and economic value to support provider purchasing decisions amid financial pressures.
Assess reimbursement exposure and potential policy changes affecting device utilization and market access.
Monitor bipartisan legislative opportunities around FDA modernization and regulatory pathways.
What health industry executives can expect from the 120th Congress
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