Using multiple poll results, an article published in the February 2, 2023 issue of the New England Journal of Medicine seeks to explain how the outcome of the 2022 mid-term election is likely to affect health policy issues. Data are derived from three types of polls: (1) a 2022 national exit poll, comprising the responses of voters as they exited voting places and those from telephone and online interviews with those who had voted before election day; (2) a national poll of voters conducted by Harvard T.H. Chan School of Public Health at the time of the election, including responses from telephone and online interviews with those who had already voted and likely voters during the week leading to election day; and (3) nine other polls conducted by telephone, online, or both with samples of U.S. adults between September 2020 and October 2022, with one exception.
A general conclusion is that after the 2022 election, critical health policy issues will face a sharply divided Congress, which is likely to hinder their resolution. Reflecting attitudes of their own parties’ voters, Republican and Democratic members in Congress will differ not only in their support for specific policies, but also in underlying values, e.g., in a December 2020 poll of the general public, 87% of Democrats said it is the responsibility of the federal government to make sure all Americans have health care coverage, as compared with only 22% of Republicans. It can be expected that Republicans are likely to oppose any major expansion in domestic spending, including for health-related issues. A majority of Republicans believe the major domestic spending bills proposed by the Biden administration have been inflationary, while a majority of Democrats do not. In a March 2022 poll of the public, 87% of Democrats had a favorable view of the Affordable Care Act (ACA) as compared with 21% of Republicans. Thus, enacting any extensive ACA enlargement is unlikely. Reducing health care costs and drug prices are a top issue, but whether any agreements can be reached is unclear.
Periodically, some high drama unfolds when there is a necessity to raise the national debt ceiling. For example, when President Barack Obama was in office in 2011, an impasse was not resolved until a couple of days before the ceiling was about to be reached. Whenever that situation occurs, financial markets can become quite agitated as the nation appears unable to continue meeting its financial obligations. Yet, the ceiling was raised with less effort three times when Donald Trump was president, a period in which Republicans were willing to cooperate even though the amount of debt increased by eight trillion dollars.
Currently, however, members of that party are much less inclined to support an increase unless it is accompanied by concrete steps to reduce federal spending. Whether popular entitlement programs, such as Medicare and Social Security might be targets is worrisome. Steady growth in the portion of the population age 65 and older, combined with the fact that many of these individuals have two or more chronic health problems, essentially means that such expenditures will continue to increase.