The midterm elections have rendered a largely split Congress, with Democrats maintaining a narrow majority in the Senate and Republicans flipping the House. 

Most policy wonks agree the divided Congress will lead to a much slower year or two on the health policy front, with no major legislation likely to be passed.

But there are still some factors at play that could influence health policy despite the gridlock.

For one, Sen. Bernie Sanders, (I-VT), is set to head the Senate Health, Education, Labor and Pensions (HELP) Committee, replacing current chair Sen. Patty Murray, (D-Wash.), who will step down to head the Senate Appropriations Committee. 

With Sanders as chairman, the committee could be poised to attempt efforts in several areas, including pushes for more drug pricing regulation.

Sen. Bill Cassidy, (R-LA), a gastroenterologist who is considered a more moderate Republican, is likely to step up as Ranking Member of the HELP committee, taking over for outgoing Sen. Richard Burr, (R-N.C.)

Though the move isn’t official yet, Sanders’ office said he would take the role if offered to him. Mike Casca, a spokesman for Sanders, told VTDigger that if Sanders takes on the role, “he will focus on universal healthcare, lowering the cost of prescription drugs, increasing access to higher education and protecting workers’ rights on the job.”

It’s likely that the split Congress won’t allow for any major movement on those key issues. However, with Sanders at the helm, the committee could revisit some of his longtime healthcare priorities and give him a soapbox from which to voice his priorities. 

He’s been a longtime proponent of the “Medicare for All” approach to the healthcare system, which would create a single-payer national health insurance program to ensure all Americans have coverage.

In May, the Senate Budget Committee held a hearing on the Medicare for All Act of 2022 that Sanders sponsored. Sanders argued that the legislation would take four years to transition the U.S. from its current health system into a single-payer system. He also cited a 2020 Congressional Budget Office estimate that a single-payer healthcare system would reduce spending by $650 billion per year.

Sanders has also been a vocal critic of the pharma industry, recently supporting legislation included in the Inflation Reduction Act that gave Medicare the power to negotiate the prices of certain drugs. 

Additionally, he would likely voice support for further drug pricing measures – something Health and Human Services (HHS) Secretary Xavier Becerra has noted the federal government plans to explore.

Sanders has also argued in the past that Medicare should have the same powers as the Department of Veterans Affairs in negotiating lower drug prices.

For his part, Cassidy has shown support for different ways of handling high drug costs – such as Louisiana’s efforts back in 2019 to create a new way of covering high price hepatitis C treatments. In that program, the state would pay a subscription fee to drug companies, known as the “Netflix model,” and then get unlimited access to the drug.

In the face of a bitterly divided federal government, both Sanders and Cassidy will have to find bipartisan ways to move the needle on most healthcare issues. The roles won’t be official until next year, however, in the new Congress.