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 Legislative and Policy

Midterm Election Results and What They Mean for Maternal and Child Health – Initial Analysis

Beyond the big headline of the midterm elections – that the Democrats took control of the House of Representatives and the Republicans retained control of the Senate – are several implications for maternal and child health. Below are some initial takeaways on what the midterm election results mean for maternal and child health as we close out the 115th Congress and move into the 116th Congress in 2019.

As a general note, keep in mind that this is an important time for advocates and supporters of maternal and child health to identify your new members of Congress and reach out to begin to develop relationships with the members and their staff. As always, feel free to use the AMCHP Government Affairs Team – Amy Haddad ( and Alyson Northrup ( – as a resource.

House Appropriations Committee: With Democrats taking control of the House, the chairmanship of the House Appropriations Committee will change from the current chairman, Rep. Rodney Frelinghuysen (R-N.J.), to a Democrat, presumably Rep. Nita Lowey (D-N.Y.), who is the current ranking member of the committee. AMCHP recognized Rep. Lowey in 2018 with its Legislative Champion for MCH Award for her leadership throughout her Congressional career to advance maternal and child health, particularly her work to advance women's and children's health priorities in her role on the House Appropriations Committee. Rep. Lowey formerly served as a member of the House Appropriations Committee's Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS).

The House Appropriations Committee's Subcommittee on Labor-HHS, which has jurisdiction for all HHS agencies, will similarly change leadership from the current chairman, Rep. Tom Cole (R-Okla.), to a Democrat, presumably Rep. Rosa DeLauro (D-Conn.), who is the current ranking member of the subcommittee. Rep. DeLauro is also a past recipient of AMCHP's Legislative Champion for MCH Award for her longstanding support and advocacy for the Title V Maternal and Child Health Services Block Grant.

As background, the House Appropriations Committee has jurisdiction for Congress' annual spending bills along with the Senate Appropriations Committee. The responsibility for drafting and passing the federal government's discretionary appropriations legislation gives these committees significant influence over federal programs and policies to advance maternal and child health (among many other programs and policies). In general, chairmen of committees and subcommittees have particular influence over the work of those bodies, because they set the committees' agendas.

House Energy and Commerce Committee: The chairmanship of the House Energy and Commerce Committee, which has jurisdiction for public health and Medicaid legislation (among other areas) will change hands from the current chairman, Rep. Greg Walden (R-Ore.), to a Democrat, presumably Rep. Frank Pallone (D-N.J.). Rep. Pallone has a long history of focusing on health care legislation in Congress, including passage of the Affordable Care Act and efforts to defend the law. As Rep. Pallone's website states, "He is particularly passionate about efforts to improve health outcomes for children, women, and the underserved."

The House Energy and Commerce Committee's Subcommittee on Health will similarly change leadership from the current chairman, Rep. Michael Burgess (R-Texas), to a Democrat. The ranking member of the subcommittee, Rep. Gene Green (D-Texas), will retire at the end of the current Congress this year. The next chairman of the subcommittee is to be determined.

Senate Appropriations Committee: The leadership of the Appropriations Committee and its Subcommittee on Labor-HHS is unlikely to change going into the new Congress in 2019. Current Committee Chairman Richard Shelby (R-Ala.) and Ranking Member Patrick Leahy (D-Vt.) were not up for reelection in 2018. Similarly, current Subcommittee Chairman Roy Blunt (R-Mo.) and Ranking Member Patty Murray (D-Wash.) were not up for reelection. Just one current member of the Senate Appropriations Committee, Sen. Cindy Hyde-Smith (R-Miss.), has an election outcome that is still to be determined. All other members either weren't up or won reelection in 2018, so the full makeup of the committee should remain fairly stable, though committee assignments may shift a bit once the new Congress begins.

Senate Health, Education, Labor, and Pensions Committee: The leadership of this committee is unlikely to change going into the new Congress. Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) were not up for reelection in 2018. No members of the committee lost reelection in 2018. Committee member Sen. Orrin Hatch (R-Utah) is retiring at the end of the year, which will open a space for one new committee member on the Republican side.

Election Results for Close Races with MCH Implications:

  • Rep. Jaime Herrera Beutler (R-Wash.), who is the lead sponsor of H.R. 1318, the Preventing Maternal Deaths Act, won reelection in a close race in the 3rd district in Washington state. Rep. Herrera Beutler is also a co-chair of the House Maternity Care Caucus and a 2018 recipient of AMCHP's Legislative Champion for MCH Award. She is also a member of the House Appropriations Committee and the House Appropriations Committee's Subcommittee on Labor-HHS.
  • Sen. Heidi Heitkamp (D-N.D.) lost her reelection to Kevin Cramer, who is the current representative for North Dakota's sole congressional district. Sen. Heitkamp is the lead sponsor of S. 1112, the Maternal Health Accountability Act, which is the Senate companion to H.R. 1318, the Preventing Maternal Deaths Act. AMCHP strongly supports S. 1112/H.R. 1318 and is advocating for passage of the bill before the end of this year. If the bill does not pass this year, there would likely be a new lead Senate sponsor of the bill in the 116th Congress. Sen. Shelley Moore Capito (R-W.Va.) is the lead Republican sponsor of S. 1112 and has been a strong champion for its passage; she may take on the lead sponsorship role for the bill or another senator might step forward.

3 States Vote to Expand Medicaid via Ballot Measure

Voters in Idaho, Utah, and Nebraska approved ballot measures to expand Medicaid in their states to individuals with incomes up to 138 percent of the poverty level ($16,753 for an individual in 2018). According to Kaiser Health News, roughly 300,000 uninsured adults in these three states would become newly eligible for Medicaid under the expansion.