Democrats take the House, giving the ACA a safety net for now

Democrats took control of the House of Representatives on Tuesday night, capturing 26 seats in the House, while Republicans maintained a firm grip on the Senate, adding two seats.

Several Senate races, including Arizona, Montana and Florida, were still too close to call as of Wednesday morning. The House still had more than 20 seats up for grabs, but The New York Times was predicting Democrats would occupy 229 seats to the Republican's 206.

While it's not quite the “blue wave” many had hoped for, Democratic control of the House puts a repeal of the Affordable Care Act out of reach. GOP leaders hinted before the election that they might attempt another repeal should they have the votes to make it happen. It also limits the Medicare and Medicaid funding cuts that could pass through Congress in the next two years. 

Of course, the ACA still faces a legal challenge, with a Texas judge expected to hand down a decision any day now. 

Healthcare became a political football for candidates across the country as Democrats pitched the issue as a central theme to voters and promised to maintain protections in the Affordable Care Act. Meanwhile, Republican candidates were forced to confront their past votes to repeal the law.

President Donald Trump routinely promised that Republicans would protect pre-existing conditions despite the administration’s efforts to allow broader use of short-term plans and Department of Justice’s decision not to defend the ACA against a court challenge. At times, his message was muddled, but that didn’t seem to impact support from his base.

It was a notable reversal from previous elections, when Democrats were hesitant to address healthcare given the ACA’s unpopularity. But since then, the law has been embraced by much of the country and Republicans were forced on their heels to explain what they would do to improve access and reduce rising costs.

State-level elections could also shift the trajectory of health policy across the country. Two states voted to expand Medicaid, while Democratic governors in three states picked up key wins on a platform of expansion.

In D.C. the House-Senate split may force Congress to take a more compromising approach on healthcare—a method that hasn’t been a hallmark on the Hill for some time. But healthcare costs aren’t going down, and coverage is likely to be a sticking point in the years leading up to the 2020 election.