The results of some congressional races may foreshadow who will have outsize health policy influence in Congress next year.

Congress will face decisions over whether to renew premium marketplace subsidies, how to pay for federal health policy programs and whether and how to address pharmacy benefit manager practices, drug pricing and other key health issues.

While Republicans have claimed victory in the Senate and the White House, the House was still in play as of Wednesday afternoon.

CQ Roll Call identified eight races whose outcomes will have an impact on health priorities next year and what could happen next.

Losses

Sen. Jon Tester, D-Mont.

Tester has been a leading advocate on veterans and rural health issues since he was first elected in 2006.

Since 2021, he’s served as chairman of the Senate Committee on Veterans’ Affairs and has seen a number of his health-related bills become law. He was a major player in the passing of a law that expanded the health care and disability benefits for veterans who were exposed to toxins from burn pits while deployed.

He has been active on prioritizing mental health for rural veterans and reducing suicide deaths and on oversight of Veterans Affairs programming including its digital health record initiative.

His bill authorizing major medical facility projects became law in 2021.

Sen. Sherrod Brown, D-Ohio

Brown chairs the Senate Finance Subcommittee on Social Security, Pensions, and Family Policy and also serves on the Veterans’ Affairs Committee.

Brown, who was first elected to the Senate in 2006, has advocated for paid family and medical leave and expanding the child tax credit.

Brown has worked on opioid legislation including a provision related to neonatal abstinence syndrome included as part of the 2018 bipartisan opioid law and anti-fentanyl tracking provisions part of a 2024 national security law.

He authored a 2008 law that reauthorized grants for the Healthy Start program, which prevents pregnancy disparities and is housed under the Health Resources and Services Administration.

Too close to call

Sen. Bob Casey, D-Pa.

Casey chairs the Special Senate Committee on Aging and has been a voice for improving access to long-term care for older people and people with disabilities and supporting family caregivers. Casey has also been active on health coverage for children through Medicaid and the Children’s Health Insurance Program. As of late Wednesday, he trailed behind Republican Dave McCormick, but the race was still too close to call.

Were Casey to lose, he’d leave behind open seats on both the Senate Health, Education, Labor and Pensions Committee and the Finance Committee. Casey has served in the Senate for two terms and has been known for working across the aisle.

Wins

Rep.-elect Sarah McBride, D-Del.

McBride will be the first openly transgender member of Congress and the highest ranking transgender elected-official in the country in 2025.

On the state level, legislative battles over gender-affirming care for transgender patients have intensified. It’s likely something Congress will continue to legislate and conduct oversight on next year.

Soon to represent the state’s at-large congressional district, McBride will bring a new face to these discussions.

‘We can open some of the most closed-off hearts and minds,” she told Roll Call in August.

In 2013, McBride helped push Delaware to prohibit discrimination based on gender identity. She was elected to the state Senate in 2021 and then chaired the Health and Social Services Committee and worked to pass statewide paid medical and family leave legislation — inspired by her late husband’s battle with cancer.

Rep.-elect Kelly Morrison, D-Minn.

Morrison is poised to become the only OB-GYN in Congress who supports abortion rights during the next Congress.

Congress’ other two OB-GYNs are Republicans — Sen. Roger Marshall of Kansas and retiring Rep. Michael C. Burgess of Texas. The majority of physicians in Congress are Republicans, with only four Democrats among the 19 elected in the 118th Congress. Morrison’s victory comes as seven states voted this week to add abortion protections to their state constitutions.

Democrats made abortion rights their top issue in 2024, and it could be on the table again for Congress next year. While in the Minnesota state legislature, Morrison played a role in passing multiple bipartisan health bills including a 2020 state drug transparency law and a law that eases coverage disruptions for patients who require health services that employ prior authorization.

Rep.-elect Bob Onder, R-Mo.

Onder was previously a state legislator who served in both the Missouri House and Senate with a background in law and medicine. The former physician is board certified in allergy and immunology as well as internal medicine.

As a Missouri state senator, he chaired the Health and Pensions Committee and has been active on legislation that opposed COVID-related public health mandates and gender-affirming care for transgender youth.

He was a major player in shaping a 2019 Missouri law that banned nearly all abortions. The state began implementing the law after the Dobbs decision in 2022. This week, Missouri voted to codify the right to an abortion.

Rep.-elect Mike Kennedy, R-Utah

Kennedy, a state senator and former family physician, touted his record sponsoring legislation that would ban transgender surgeries for minors. He also voted against COVID-19 vaccine mandates during the pandemic.

Kennedy also brings an anti-abortion track record to Congress. In 2013, he voted in support of a bill requiring the state department of health to prepare an annual report on abortions performed. In 2018, Kennedy voted for a bill barring abortions based on the diagnosis of Down syndrome while pregnant.

On the campaign trail, Kennedy pledged to focus on expanding health savings accounts, lowering the price of prescription drugs, including expanding the availability of generic drugs, and promoting transparency in health care costs.

Rep.-elect Maxine Dexter, D-Ore.

Dexter, a state representative and a pulmonary and critical care physician, will be part of the new class of health care professionals elected to Congress.

Dexter campaigned on standing up to big pharma, spearheading federal investments for drug treatment programs, and protecting reproductive health care rights.

In the Oregon state House of Representatives, Dexter led legislation to protect health care providers from prosecution for providing abortion services and gender-affirming care.

Inspired by her experience caring for a patient who died from an overdose, Dexter sponsored a legislative package in 2023 that funded treatment programs and expanded access to naloxone.

Her priorities in Congress include policies to “rigorously regulate” pharmacy benefit managers and to ultimately move toward a single payer health care system.

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