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November 7, 2018

From our CEO: What now? Health Care After the Election

Alan Balch, PhD | November 7, 2018

Our mantra, during every election, is that your vote is your voice. With record turnouts, I am pleased to report that for most voters, health care as an issue transcended partisan politics.


This trend manifested in Utah, Nebraska and Idaho, as voters all opted to expand Medicaid in their states, extending coverage to over 300,000 people. Likewise, in Maine, Kansas and Wisconsin, voters elected governors who campaigned on expanding Medicaid against an outgoing administration that opposed the program.


Of course, not all gains will be immediate, and in some cases, there will be no gains at all. With Democrats in control of the House and Republicans in control of the Senate, there will likely be very little legislative movement in health care. We will likely see the end of attempts to repeal the Affordable Care Act. Thankfully, too, moves to make massive cuts to safety net programs like Social Security and Medicare will likely be stymied.


Democratic control of the House, however, does not mean that we will see much success for the Democratic health care agenda. With Republicans deepening their control of the Senate, we can expect any Democratic-led legislation to fail in that chamber. The same is true of Republican-led legislation in the Senate, which would likely fail in the House. I am hopeful, however, that there may be room for moderate bills that have bipartisan support. President Trump has indicated his willingness to address drug pricing; here, then, may be an area in which Democrats and Republicans could cooperate.


As for the Administration’s regulatory work, the election may not have much of an effect on their agenda.  They will likely continue to use the agencies to transform Medicaid and promote deregulation. With a Democratic House, though, comes Democratic oversight. Democrats could likely question CMS as it considers additional Section 1115 Medicaid work requirement waiver applications. However, it may increasingly be up to the states to promote patient protections and other gains that are still under attack through both regulatory and judicial channels.


It is crucial that you continue to advocate for patients in your neighborhood and nationwide. While we may feel secure that a massive change is not about to upheave millions’ of Americans health care, there are still multiple venues in which we must raise our voices in support of access to affordable, quality care. As always, we will keep you informed and call on you to act with us in support of person-centered policies. If you have any questions or wish to volunteer, please visit us at


Alan Balch, PhD, is the Chief Executive Officer of the National Patient Advocate Foundation and the Patient Advocate Foundation.