MIDTERM ELECTION ANALYSIS
The 2014 election resulted in new Republican representation in both the House and Senate, as well as
state Gubernatorial races. As of November 11, the most likely breakdown for the 114th Congress is a
54-46 Republican majority in the Senate (although the Alaska race is still undecided and the Louisiana
Senate race will be decided by a runoff December 6) and 244-184 in the House.
The presumptive new Senate Majority Leader, Mitch McConnell (R-KY), has indicated his intention to
return to “regular order” in the Senate, allowing more open debate and more extensive consideration of
amendments. This may lead to opportunities for bipartisan cooperation, but Leader McConnell will face
pressure to limit the influence of Democrats. If he yields to this pressure, bipartisan cooperation may be
more difficult. For House leadership, a stronger majority likely improves their ability to pass legislation
with only Republican votes. Previously, the need for Democratic votes to pass the SNAP reauthorization,
fiscal cliff legislation, Violence Against Women Act, and other measures resulted in more moderate
legislation than their caucus would otherwise prefer. More extreme House legislation may be in store
given the additional seats and reduced need for bipartisan votes.
For the 114th Congress, Republicans plan to strike a balance between demonstrating they can govern
and satisfying their conservative base through continued opposition to President Obama. How much
they focus on bipartisan legislation that could be signed by President Obama or conservative messaging
legislation likely to be vetoed or filibustered is an open question. The new Congressional leadership has
opportunities to pass bipartisan legislation on infrastructure, criminal justice reform, tax reform, housing
finance reform and more if they pursue bipartisan legislation in good faith. Housing finance reform in
particular could be beneficial for the HCH community if funding for the National Housing Trust Fund is
included.
This election also brought significant changes in State Government, which is particularly important for
gaining Medicaid expansion is the remaining 23 states. Republican candidates won many gubernatorial
races to include Maine, Massachusetts, Illinois, Florida, Georgia, Wisconsin, Michigan, Kansas, and
Maryland. The Democrats held the Governor’s office in Connecticut and New Hampshire, won the
Governor’s race in Pennsylvania, and are currently in the lead in Vermont. Advocates had hoped that
changes at the State level may improve the chances of expanding Medicaid in some states, but Alaska is
the only state where it appears those chances have improved (with an Independent candidate currently
in the lead). States such as Ohio and Arkansas may also face significant challenges in reauthorizing their
Medicaid expansions because of opposition in their legislatures. Despite these results, new Medicaid
expansions are still possible. Utah and Indiana are actively negotiating with CMS and their state
legislatures; and leaders in Wyoming, Tennessee, North Carolina and South Dakota have all expressed
some interest in exploring Medicaid expansion options. Hence, there are still many opportunities to
advocate for Medicaid, given new leadership and the resulting policy and budget agendas.
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
UPCOMING FEDERAL LEGISLATIVE ACTIVITY
Potential Issues in the 114th Congress
FY16 Budget:
With Republicans controlling both chambers of Congress, they will have the opportunity to pass a
Budget Resolution without relying on Democratic votes. They will likely stick to the tenets of previous
House Budget Resolutions: balancing the budget in ten years, protecting current and near-future Social
Security and Medicare recipients, and protecting or increasing defense spending. If these conditions are
retained, proposals to make significant changes to safety net programs are likely, such as:
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Block grants or reductions in SNAP (food stamps)
Changes to Medicaid that may reduce federal support, change benefits, or alter eligibility
Changes to the Budget Control Act that allow deeper cuts to domestic spending and increases to
defense spending
Changes to the ACA:
The 114th Congress is likely to continue voting to fully repeal the ACA, which is largely symbolic given
Presidential veto power. Attention will likely turn to other pieces of the law, to include:
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Repealing the requirement that employers must offer health insurance
Repealing the requirement that most individuals must have health insurance
Allowing partial expansions to state Medicaid programs to qualify for federal matches, or
changing the eligibility threshold to 100% FPL or below
Repealing provisions that stabilize the prices of insurance offered on the State and Federal
Marketplaces. This could lead to increased health care costs across the board.
Eliminate the Independent Payment Advisory Board designed to revise Medicare payment rates
and reduce health care inflation
Housing Finance Reform:
Reforming the federal housing finance system is possible in the 114th Congress. This would primarily
reform Fannie Mae and Freddie Mac, the entities that provide loan guarantees for potential home
buyers, but a dedicated source of funding for affordable housing would likely also be included. Existing
bipartisan legislation in both the House and Senate would provide up to $4 billion a year to the National
Housing Trust Fund through fees on Federal Housing Finance transactions. A Republican Congress may
be willing to retain these provisions, although that is not guaranteed. The House Republican version of
Housing Finance Reform abolishes the National Housing Trust Fund.
Primary Care Funding Cliff:
The Primary Care Funding Cliff may be addressed during the Lame Duck Session of the 113th Congress,
but further advocacy may be needed next year. The funding cliff represents a scheduled decrease in
Health Center funding due to the expiration of the Health Center Trust Fund included in the ACA.
Including funding in the FY16 House and Senate Budget Resolutions would be the first step in the 114th
Congress.
Budget Reconciliation:
While the control of the Senate is certainly important, most legislation will still need 60 votes to pass.
One exception is a legislative process known as the Budget Reconciliation, which only needs 51 votes in
the Senate, and could be used to pass changes to the ACA, Medicaid, tax policy, and other areas.
President Obama will still be able to veto a Budget Reconciliation bill.
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
Lame Duck
FY15 Appropriations:
FY15 funding currently expires on December 12 and Congressional action is needed to avoid a
government shutdown. The best result would be a full-year Omnibus Appropriations Bill, which provides
new funding levels for all appropriated programs. Affordable housing programs in particular need an
increase over FY14 levels if they are to keep up with rising rental costs and prevent further reductions of
affordable housing stock. If not an omnibus, Congress will seek to extend the current continuing
resolution (CR) for either three months or the rest of the fiscal year. A CR would flat fund most
programs, resulting in a decrease in the number of affordable housing units that can be funded due to
rising rental costs. Even with a CR, small adjustments can be made and it will be critical that affordable
housing programs receive them. If the CR is only extended for three months, the new Congress will have
the opportunity to make significant changes to FY15 funding levels, potentially increasing defense
spending and decreasing non-defense. Republican leadership has expressed the desire to complete FY15
funding during the Lame Duck, but some members have expressed the desire to wait until 2015 when
they will have more power to craft spending levels. The threat of partisan fighting and a government
shutdown is greater if Congress chooses only to extend the CR for three months.
Primary Care Funding Cliff:
The other Council priority during the Lame Duck will be to address the Primary Care Funding Cliff since
the 113th Congress is marginally more favorable due to more dependable support for Health Centers by
Democrats. This issue will need to be addressed outside the regular appropriations process because the
strict limits on total spending imposed by the Budget Control Act and subsequent sequestration cuts
prevent increasing the health center appropriation. The President proposed an additional $2.7 billion in
mandatory Health Center funding for FY16, FY17, and FY18. The President’s proposal would freeze
Health Center funding below the FY15 level, at the approximate FY14 level and cost about $8 billion over
three years. The National Association of Community Health Centers (NACHC) is seeking $20 billion over
five years, maintaining the FY15 level and including increases of $100-$150 million through FY20.
Any mandatory funding allocated for Health Centers will need to be included in a larger legislative
package. NACHC has been reaching out to Congressional leadership and the National HCH Council will be
contacting members on the relevant Health Center authorizing committees (Energy and Commerce in
the House; HELP in the Senate). Assistance from local HCH projects in contacting these offices would
be most helpful! Congress would need to determine other details as well, such as how much funding to
provide, for how long, and with what (if any) offsetting reductions elsewhere.
NEEDED ACTION
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Assist with FY15 Appropriations and Primary Care Funding Cliff advocacy during the Lame Duck
Session. Call your members of Congress using the Capital Switchboard, 1(877) 210-5351, and
urge them to support our positions outlined above. View this Mobilizer for further information
and look for email communications from Health Policy Organizer Dan Rabbitt if your members of
Congress are on relevant committees.
Introduce yourself to your (re)elected officials at the federal and state level. Use these template
letters for members of Congress, state officials in Medicaid expansion states, and state officials
in non-expansion states.
Sign up for the National HCH Council action alert, the Mobilizer.
Ask your Board, staff, and consumer leaders to sign up for the Mobilizer as well.
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
U.S. SENATE: ELECTION RESULTS AND NEW COMMITTEE CHAIRS
Republicans: 52
Undecided: 2
Democrats: 46
Senate Republican Pickups: 7 (of races called)
State
Arkansas
Colorado
Iowa
Montana
North Carolina
South Dakota
West Virginia
Winner
Tom Cotton (R)
Cory Gardner (R)
Joni Errnst (R)
Steve Daines (R)
Thom Tillis (R)
Mike Rounds (R)
Shelley Moore Capito (R)
Incumbent
Sen. Mark Pryor (D)
Sen. Mark Udall (D)
Open: Sen. Tom Harkin’s seat
Open: Sen. Max Baucus’ seat
Sen. Kay Hagan (D)
Open: Sen. Tim Johnson’s seat
Open: Sen. John Rockefeller’s seat
One Undecided Election, One Runoff
State
Alaska
Louisiana
Republican
Dan Sullivan
Rep. Bill Cassidy
Democrat
Mark Begich
Sen. Mary Landrieu
Status / Runoff Date
Votes Being Counted
December 6
New Senators (including pickups listed above)
(Make sure to reach out to your new members!)
State
Arkansas
Winner
Tom Cotton (R)
Colorado
Cory Gardner (R)
Georgia
Iowa
Michigan
David Perdue (R)
Joni Ernst (R)
Gary Peters (D)
Montana
Steve Daines (R)
Nebraska
North Carolina
Oklahoma
Ben Sasse (R)
Thom Tillis (R)
James Lankford (R)
South Dakota
West Virginia
Mike Rounds (R)
Shelley Moore Capito (R)
Notes
House Republican Member of the Financial Services
and Foreign Affairs Committee
House Republican Member of the Energy and
Commerce Committee
Former CEO of Dollar General
Former State Senator
House Democrat sits on Financial Services
Committee
House Republican sits on Transportation
Committee and Homeland Security Comm.
Midland University President
Former State House Speaker
House Republican Policy Committee member who
sits on both the House Budget Committee and on
the House Oversight Committee
Former Montana Governor
House Republican Chair of Consumer Markets
Subcommittee of the House Financial Services
Committee
Projected Senate Committee Leaders
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
Committee
Appropriations
Budget
Chairman
Thad Cochran (R-MS)
Jeff Sessions (R-AL)
Banking
Finance
HELP
Judiciary
Veterans
Richard Shelby (R-AL)
Orrin Hatch (R-UT)
Lamar Alexander (R-TN)
Chuck Grassley (R-IA)
Richard Burr (R-NC)
Ranking Member
Barbara Mikulski (D-MD)
Bernie Sanders (I-VT) or Bill
Nelson (D-FL)
Sherrod Brown (D-OH)
Ron Wyden (D-OR)
Patty Murray (D-WA)
Pat Leahy (D-VT)
Sherrod Brown (D-OH)
HOUSE OF REPRESENTATIVES: ELECTION RESULTS AND NEW COMMITTEE CHAIRS
Republicans: 244
Undecided: 7
Democrats: 184
House Republican Pickups
State
Maine - 2
Nevada - 4
Texas - 23
Georgia - 12
New York - 1
Iowa -1
Illinois - 12
Florida - 26
New York - 21
West Virginia - 3
Illinois - 10
New Hampshire - 1
North Carolina - 7
New York – 24
Utah – 4
Winner
Bruce Poliquin
Cresent Hardy
Will Hurd
Rick Allen
Lee Zeldin
Rod Blum
Mike Bost
Carlos Curbelo
Elise Stefanik
Evan Jenkins
Robert Dold
Frank Guinta
David Rouzer
John Katko
Mia Love
Incumbent
Emily Cain
Steve Horsford
Pete Gallego
John Barrow
Timothy Bishop
Pat Murphy
Bill Enyart
Joe Garcia
Aaron Woolf
Nick J. Rahall
Brad Schneider
Carol Shea-Porter
Jonathan Barfield
Daniel Maffei
Doug Owens
House Democratic Pickups
State
Florida – 2
Nebraska - 2
Winner
Gwen Graham
Brad Ashford
Incumbent
Steve Southerland
Lee Terry
New House Members (including pickups listed above)
(Make sure to reach out to your new members!)
Seat
Alabama - 6
Arizona - 7
Arkansas - 2
Arkansas - 4
Winner
Gary Palmer (R)
Ruben Gallego (D)
French Hill (R)
Bruce Westerman (R)
Who They Replace
Replaces Spencer Bachus (R), retiring
Replaces Ed Pastor (D), who is retiring
Replaces Tim Griffin (R), who is retiring
Replaces Tom Cotton (R), ran for Senate
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
California - 11
California -31
California - 33
California - 35
Mark DeSaulnier (D)
Pete Aguilar
Ted Lieu (D)
Norma Torres (D)
California – 25
California - 45
Colorado - 4
Florida - 2
Steve Knight (R)
Mimi Walters (R)
Ken Buck (R)
Gwen Graham (D)
Florida - 19
Curt Clawson (R)
Florida - 26
Georgia - 1
Carlos Curbelo (R)
Buddy Carter (R)
Georgia - 10
Jody Hice (R)
Georgia - 11
Barry Loudermilk (R)
Georgia - 12
Hawaii - 1
Rick Allen (R)
Mark Takai (D)
Illinois - 10
Illinois - 12
Iowa - 1
Iowa - 3
Maine - 2
Robert Dold (R)
Mike Bost (R)
Rod Blum (R)
David Young (R)
Bruce Poliquin (R)
Massachusetts - 6
Michigan - 4
Michigan - 8
Michigan - 11
Michigan - 12
Michigan - 14
Minnesota - 6
Montana - AL
Nebraska – 2
Nevada - 4
New Jersey - 1
New Hampshire - 1
New Jersey - 1
New Jersey - 3
New Jersey - 12
New York - 1
New York - 4
Seth Moulton (D)
John Moolenaar (R)
Mike Bishop (R)
Dave Trott (R)
Debbie Dingell (D)
Brenda Lawrence (D)
Tom Emmer (R)
Ryan Zinke (R)
Brad Ashford (D)
Cresent Hardy (R)
Donald Norcross (D)
Frank Guinta (R)
Donald Norcross (D)
Tom Macarthur (R)
Bonnie Watson Coleman (D)
Lee Zeldin (R)
Kathleen Rice (D)
Replaces George Miller (D), retiring
Replaces Gary Miller (R), retiring
Replaces Henry Waxman (D), retiring
Replaces Gloria Negrete McLeod (D), who
ran for local office
Replaces Buck McKeon (R), retiring
Replaces John Campbell (R), retiring
Replaces Cory Gardner (R), ran for Senate
Defeated Steve Southerland (R)
Replaces Trey Radel (R), who resigned in
January 2014
Defeated Joe Garcia (D)
Replaces Jack Kingston (R), lost Senate
primary
Replaces Paul Broun (R), lost Senate
primary
Replaces Phil Gingrey (R), who lost Senate
primary
Defeated John Barrow (D)
Replaces Colleen Hanabusa (D), who lost
Senate primary
Defeated Brad Schneider (D)
Defeated Bill Enyart (D)
Replaces Bruce Braley (D), ran for Senate
Replaces Tom Latham (R), who is retiring
Replaces Michael Michaud, ran for
Governor
Replaces John Tierney (D), lost primary
Replaces Dave Camp (R), who is retiring
Replaces Mike Rogers (R), who is retiring
Replaces Kerry Bentivolio (R), lost primary
Replaces John Dingell (D), who is retiring
Replaces Gary Peters (D), ran for Senate
Replaces Michele Bachmann (R), retiring
Replaces Steve Daines (R), ran for Senate
Defeated Lee Terry (R)
Defeated Steven Horsford (D)
Replaces Rob Andrews (D), who left office
Defeated Carol Shea-Porter (D)
Replaces Rob Andrews (D), who left office
Replaces Jon Runyan (R), who is retiring
Replaces Rush Holt (D), who is retiring
Defeated Tim Bishop (D)
Replaces Carolyn McCarthy (D), retiring
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
New York - 21
New York - 24
North Carolina - 6
North Carolina - 7
North Carolina - 12
Oklahoma - 5
Elise Stefanik (R)
John Katko (R)
Mark Walker (R)
David Rouzer (R)
Alma Adams (D)
Steve Russell (R)
Pennsylvania - 6
Pennsylvania - 13
Ryan Costello (R)
Brendan Boyle (D)
Texas - 4
Texas - 23
Texas - 36
John Ratcliffe (R)
Will Hurd (R)
Brian Babin (R)
Utah - 4
Virginia - 7
Virginia - 8
Virginia - 10
Washington - 4
West Virginia - 2
Mia Love (R)
David Brat (R)
Don Beyer (D)
Barbara Comstock (R)
Dan Newhouse (R)
Alex Mooney (R)
West Virginia - 3
Wisconsin - 6
Evan Jenkins (R)
Glenn Grothman (R)
Five Undecided Elections, Two Runoffs
Seat
Republican
Arizona - 2
Martha McSally
California - 7
Doug Ose
California - 16
Johnny Tacherra
California - 26
Jeff Gorell
New York - 25
Mark Assini
Louisiana - 5
Zach Dasher
Louisiana - 6
Dan Claitor
Replaces Bill Owens (D), who is retiring
Defeated Dan Maffei (D)
Replaces Howard Coble (R), retiring
Replaces Mike McIntyre (D), retiring
Replaces Mel Watt (D), who left office
Replaces James Lankford (R), ran for
Senate
Replaces Jim Gerlach (R), who is retiring
Replaces Allyson Schwartz (D), lost
gubernatorial primary
Replaces Ralph Hall (R), who lost primary
Defeated Pete Gallego (D)
Replaces Steve Stockman (R), lost Senate
primary
Replaces Jim Matheson (D), retiring
Replaces Eric Cantor (R), lost primary
Replaces Jim Moran Jr. (D), who is retiring
Replaces Frank Wolf (R), who is retiring
Replaces Doc Hastings (R), who is retiring
Replaces Shelley Moore Capito (R), ran for
Senate
Defeated Nick Rahall (D)
Replaces Tom Petri (R), who is retiring
Democrat
Rep. Ron Barber
Rep. Ami Bera
Rep. Jim Costa
Rep. Julia Brownley
Rep. Louise Slaughter
James Mayo
Peter Williams
Status / Runoff Date
Votes Being Counted
Votes Being Counted
Votes Being Counted
Votes Being Counted
Votes Being Counted
December 6
December 6
Projected House Committee Chairs
Committee
Appropriations
Budget
Energy & Commerce
Chairman
Hal Rogers (R-KY-5)
Tom Price (R-GA-6)
Fred Upton (R-MI-6)
Financial Services
Veterans
Jeb Hensarling (R-TX-5)
Jeff Miller (R-FL-1) or Doug Lamborn (RCO-5)
Paul Ryan (R-WI-1)
Ways and Means
Ranking Member
Nita Lowey (D-NY-17)
Chris Van Hollen (D-MD-8)
Anna Eshoo (D-CA-18) or Frank
Pallone (D-NJ-6)
Maxine Waters (D-CA-43)
Corrine Brown (D-FL-5)
Sander Levin (D-MI-9)
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org
STATE GOVERNMENT: ELECTION RESULTS
GOP Gubernatorial Pickups
State
Winner
Asa Hutchison
Arkansas
Bruce Rauner
Illinois
Larry Hogan
Maryland
Charles Baker
Massachusetts
Who They Replace
Mike Beebe (D), term-limited
Pat Quinn (D), incbumbent
Martin O’Malley (D), term-limited
Deval Patrick (D), term-limited
Dem Gubernatorial Pickups
State
Pennsylvania
Winner
Tom Wolf
Who They Replace
Tom Corbett (R), incumbent
Winner
Doug Dicey (R)
David Ige (D)
Who They Replace
Jan Brewer (R), term-limited
Neil Abercrombie (D), incumbent who
lost primary
Dave Heineman (R), term-limited
Lincoln Chaffee (D), chose not to run
Rick Perry (R), chose not to run
Other New Governors
State
Arizona
Hawaii
Pete Ricketts (R)
Gina Raimondo (D)
Greg Abbott (R)
Nebraska
Rhode Island
Texas
Two Undecided Elections
Seat
Alaska
Vermont
Challenger
Bill Walker (Independent)
Scott Milne (R)
Incumbent
Sean Parnell (R)
Peter Shumlin (D)
Status
Votes Being Counted
Shumlin expected to be
appointed by legislature
GOP Legislature Pickups
State
Washington
Nevada
Colorado
West Virginia
New York
Maine
New Hampshire
West Virginia
Minnesota
New Mexico
Nevada
Chamber
Senate
Senate
Senate
Senate
Senate
Senate
House
House
House
House
House
National Health Care for the Homeless Council | P.O. Box 60427 | Nashville, TN 37206-0427 | (615) 226-2292 |www.nhchc.org