In light of the midterm election results, some hospital and health system leaders say some of the policy pressure on their organizations could be eased, while others caution that the underlying financial challenges headed into 2027 remain.
President Donald Trump still holds veto power, so a Democratic-led Congress is unlikely to fully reverse the nearly $1 trillion in Medicaid cuts from HR 1. Restoring enhanced ACA premium subsidies and reversing those cuts are near the top of House Democrats’ first-100-days agenda, and a House majority gives the party new oversight and subpoena power.
Leaders are divided on what that will mean in practice. Some hope Congress can slow or pause changes set to take effect Jan. 1, or offer more certainty on issues such as 340B. Others say the shift will not change the economics hospitals face, with reimbursement flat and costs rising, and worry that policymakers will lose their sense of urgency on safety-net care.
Several leaders said one thing will hold regardless of the results: advocacy has to stay bipartisan. They also noted that turnover in Congress means new members and their staffs will need to be brought up to speed on healthcare issues quickly.
Here is what six CEOs said Nov. 4 in reaction to election results in statements shared with Becker’s and during panels at Becker’s CEO + CFO Roundtable:
Editor’s note: Responses have been lightly edited for clarity and length.
Chris Van Gorder, president and CEO, Scripps Health (San Diego): While the election has changed who controls Congress, it doesn’t change the financial challenges hospitals will face in 2027. Democrats won’t have the votes to simply reverse major federal healthcare cuts over a presidential veto. But Congress is far from powerless. Lawmakers can use their oversight and budget authority to press for changes in how those cuts are carried out, protect critical healthcare funding where possible and work across party lines to ease the growing financial pressures on hospitals and impact on patients.
Diana Richardson, President and CEO of Merrimack Health (Haverhill, Mass.): We’re encouraged by the results of the election last night. We’re hopeful that some policy changes will slow down a little bit. I don’t think they’ll go away, but slow down. My personal fear, though, is that our state and those around us will say, “Great, the election went the right way. Everything’s fine. We don’t have to think about safety net healthcare anymore.” The truth is, we would all be struggling and having these troubles, even if none of HR 1 was on the horizon, because of those same economics — reimbursement flat, costs going up. My worry is that our legislators — both at the state level and those who represent our state at the federal level — will take the foot off the gas on looking at healthcare and safety net healthcare in particular.
Abha Agrawal, MD, founder, president and CEO of NorthStar Hospitals: A lot of people have lost [Medicaid] coverage. New requirements have come into place, and that has caused more distress. January 2027 [is] another ticking time bomb. I wonder, with the change in the politics, how that Jan. 1, 2027, timeline would be changed. Will there be enough momentum in the both houses of Congress to be able to pause some of those really terrible changes coming our way that will impact so many?
340B is always a level of concern for many community safety-net hospitals, even larger systems, which is continuously at the risk of being litigated. Would this change and give hospital CEOs some level of reassurance that 340B — and therefore access to cancer care and specialty pharmacy — would remain intact?
Mark Boucot, president and CEO of WVU Medicine’s Garrett Regional Medical Center (Oakland, Md.) and Potomac Valley Hospital (Keyser, W.Va.): From my perspective, from an advocacy perspective, it doesn’t matter whether it’s an elephant or a donkey — I’m still going to have to develop the relationship the same way. And so, for me, if they know anything about my political leanings, I’ve kind of failed. That’s how I feel. [When] I’m advocating for a community, whether I’m advocating through a Republican or Democrat, I’m still representing and telling the stories for our communities, and what it is that we need and how the changes in the legislation are affecting us as a community, and what that means to the community.
I’m blessed to run two different hospitals and two different payment models, one in the Maryland payment model, which is the largest alternative payment model in the United States … and a critical access hospital in Keyser, W.Va. It’s a unique scenario, but I think that if we do it right and we advocate right, then it really doesn’t matter. We should be able to work with both sides of the aisle. And for us, I think we have to stay neutral. That’s my own personal leaning on it.
Patti VanDort, CEO of Holland (Mich.) Hospital: At the state level, prior to the election, [Michigan] had a Democratic governor, a Democrat Senate, and a Republican House. There was a lot of stalemate — nothing got done. As of last night, now we have the Democrats in control of all three of the branches of the government in Michigan, and for us, personally, it’s been a very tumultuous time with the House — who will no longer be in January, but the House Majority Leader — who was very much a motivated adversary for healthcare, and [there was] a constant barrage of bills that really were detrimental to hospitals and health systems. I believe it’s important to work with both sides of the aisle, but that’s quite honestly taken some pressure off for us in this most recent election.
William Morice II, MD, PhD, President and CEO of Mayo Clinic Laboratories (Rochester, Minn.): No. 1, what will the swing of Congress now be able to do? What will be their focus? Will they be able to get some legislation passed, because there’s a lot of really important fixes that’ll be needed, and if they’re not addressed come January 1st, it’ll have a really negative impact on many areas of hospitals and healthcare.
And then there’s going to be a lot of relationship building. The other thing is we’re losing a lot of seasoned leadership out of Congress. That means their administrative staff are also leaving, and so these are people that took the time to be versed in the issues. [The new legislators] are going to have their new teams, so it’s almost going to be like a full-court press to get in front of some of those new representatives, and more importantly, their staff, so they can start to be versed in the issues.
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
