Editor's note: This story has been updated to reflect the Associated Press calling both Senate runoff races in Georgia for Democratic candidates
The Democrats pulled it off. Even though no Democrat since 1986 has been able to unseat a Republican senator from Georgia, the wins of Jon Ossoff and Raphael Warnock have secured the U.S. Senate for the Democrats (with Vice President-elect Kamala Harris as the tie-breaking vote), auguring a new period of unified Democratic control of the political branches of the federal government.
These wins give the party significantly more freedom to enact President-elect Biden's agenda—but that freedom will be tempered by the precarious nature of their control. In both houses of Congress, Democrats will hold razor-thin majorities, and will require virtual lockstep of all members of their party to push any legislation through both chambers. And in the Senate, any legislation that cannot be resolved through budget reconciliation will be subject to filibuster from the GOP, unless the Democrats deliver on their mission to abolish it with a unanimous vote from their caucus.
After Biden's win had been declared back in November, I outlined five predictions for how the Biden administration could approach key health care issues. By and large, I stand by those predictions: expect a greater focus on participation over performance on value-based care; industry consolidation is likely to have many unexpected twists and turns; states are likely to again become laboratories of experimentation on coverage expansion; health care spending will have to be addressed to shore up the Medicare trust fund; and some areas of compromise—on drug pricing, telehealth, price transparency, and maternal health—are genuinely possible.
But back then, I added many caveats that depended on which party would ultimately control the Senate. With that chamber's turnover, today I want to focus specifically on what a unified Congress and presidency mean for health care—and with that, six more predictions for 2021.