What a Republican Senate will mean for the healthcare industry

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Senate Republicans are likely to hold on to their majority in the next Congress, which limits what legislation former Vice President Joe Biden could do on healthcare should he assume the White House. (Getty Images/Bill Chizek)

Republicans appear likely to hold on slightly to their Senate majority after Tuesday’s elections, which could have a major impact on what healthcare legislation gets through Congress next year.

So far, Democrats have flipped two GOP Senate seats in Arizona and Colorado, and Republicans flipped a seat in Alabama. Several other races have not been called, but key Republican incumbents who were in tight races were reelected.

Meanwhile, the presidential race remains too close to call, but former Vice President Joe Biden is leading in several major battleground states as votes continue to be counted.

If Biden assumes the presidency, he would likely face major opposition among Senate Republicans to major healthcare policy proposals such as a public option and lowering the Medicare age to 60.

There could be some movement on drug pricing legislation, which generally has some bipartisan appeal. However, Republicans could likely stymie any efforts to install giving Medicare the power to negotiate over drug prices that Biden has floated.

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The Republican Senate refused to take up a House bill passed last year that gave Medicare the power to negotiate prices.

However, any “near-term congressional efforts will likely focus on bipartisan Part D redesign efforts,” according to a notice from Brian Rye, an analysis with Bloomberg Intelligence, on Wednesday. “Both parties aim to cap seniors’ out-of-pocket costs and eliminate the ‘donut hole.’”

If President Donald Trump is able to get a second term, it remains unlikely that a GOP-controlled Senate would be able to act on major healthcare priorities—like repealing the Affordable Care Act—as Democrats are expected to continue to hold the House, albeit with a shrunken majority.

There could also be changes to who oversees pivotal Senate committees on healthcare issues.

Sen. Lamar Alexander, R-Tennessee, is retiring after this year, meaning there will be a new chairman of the Senate Health, Education, Labor and Pensions Committee. Alexander was known to negotiate several major bipartisan deals with Democratic ranking member Patty Murray, D-Washington, who is expected to continue to be the top Democrat.

The senator next in line, via seniority on the panel, would appear to be Mike Enzi, R-Wyoming.

Alexander also played a pivotal role in the development of a bicameral deal on surprise medical bills with the House Energy and Commerce Committee. But the bipartisan deal collapsed late last year due to unexpected opposition from the House Ways and Means Committee. 

It remains unclear who on the Republican side would take up the mantle for surprise medical bills, which is likely to remain a top issue in the next Congress.

Meanwhile, the Senate Finance Committee, which also weighs in on major healthcare issues like drug prices, will likely continue to be led by Sen. Chuck Grassley, R-Iowa.

Grassley has worked on several bipartisan deals and has been a major proponent of lowering drug prices. He and ranking member Ron Wyden, D-Oregon, reached a bipartisan deal to cap increases for Medicare Part D drugs beyond the cost of inflation, but the legislation never reached the Senate floor due to bipartisan opposition from Republicans.