Democrats take control of Congress

As of Wednesday morning, results show that Democrats have gained at least a dozen House seats and at least seven Senate seats, with some races still being tallied and too close to call.

Democrats won both the Senate and governor's races in Texas, marking their first statewide victories since 1994. In addition, Democrats won a Senate seat in South Carolina where pediatrician Annie Andrews defeated Sen. Darline Graham. Democrats also won a Kansas Senate seat for the first time since 1932 where pastor Adam Hamilton defeated Sen. Roger Marshall, a doctor, and won a Senate seat in Michigan where Abdul El-Sayed, also a doctor, defeated Republican Rep. Mike Rogers.

Meanwhile, as of Wednesday morning, Senate races in Mississippi and Alaska were still too close to call.

The nationwide shift toward the Democratic Party extended across demographics and geographies. The exit poll conducted by the Associated Press and major television networks showed double-digit swings toward the Democrats among Latinos, Catholic voters, and voters younger than 30 compared to the 2024 Presidential election.

Republicans also saw a drop in turnout, as fewer supporters showed up on Election Day than in the 2022 midterms, according to preliminary turnout data. Early results from the NORC Civic Health & Elections Project survey found that 60% of voters said they disapproved of President Donald Trump and 81% voted for Democrats. The survey also found that voters named the economy, healthcare, and the war with Iran as their top issues.

In response to the results, Trump said Republicans lost control of Congress because he wasn't on the ballot. "I don't like to consider it a defeat for me, I wasn't on the ballot," he said in an interview on Fox News, noting that some voters simply "didn't like the candidates."

"Some of the candidates that I endorsed fought me," Trump said, adding that his base voters "didn't like that they fought me."

What the results mean for healthcare

Democrats will take control of Congress in January with an agenda that will likely touch on a variety of healthcare topics.

"Medicaid work requirements, provider taxes, state-directed payments, and eligibility provisions could become targets for oversight, implementation delays, regulatory flexibility and appropriations restrictions," the authors wrote. "With a Republican President, however, significant statutory rollback would remain difficult."

In addition, Democrats in Congress could attempt to pass a reconciliation bill with their healthcare priorities in the same way Republicans did in 2025 with OBBBA, but such an attempt is likely to be met with a veto from Trump.

That said, Trump told POLITICO in an interview Tuesday night that he'd like to work alongside Democrats to get legislation passed. "I don't want to be just sitting there for two years vetoing everything," he said.

Given the state of Congress with Trump as president, the policies that seem to have the greatest likelihood of being signed into law could be those that already attract bipartisan support, including prior authorization, physician payment reform, and reform of the No Surprises Act.

The midterm results will also give Democrats more oversight power, allowing them to more forcefully scrutinize HHS Secretary Robert F. Kennedy Jr.'s vaccine policies and the Trump administration's drug-pricing agreements. Democrats could also choose to increase their oversight of the healthcare industry more broadly, potentially targeting Medicare Advantage, hospital and healthcare consolidation, and controversial insurer practices.

And while there were many primaries this election season that showcased differences between the more progressive and centrist wings of the Democratic Party, some have been eager to downplay those divisions going forward.

"At the end of the day, the things we don't agree with, we'll figure out," one House Democratic aide said to POLITICO anonymously. "I don't think folks will want to come out of the gate with a circular firing squad."