(Nov. 5, 2026) – The fate of the 120th Congress was decided Tuesday as Americans went to the polls in droves, and the results leaned decisively blue. Kansas voters elected a Democrat to the U.S. Senate for the first time since 1932. Democrat Adam Hamilton defeated incumbent Republican U.S. Sen. Roger Marshall, receiving about 51 percent of the vote to Marshall's 46 percent. Libertarian David Graham received about three percent. The Senate race drew about $103 million in general-election advertising, making it the most expensive political contest in Kansas history.

All four members of Kansas' U.S. House Delegation won reelection Tuesday evening, meaning the state's Congressional Delegation will remain three Republicans and one Democrat. Although Kansas' U.S. House Delegation remains unchanged, the broader national election results are expected to bring significant changes to congressional leadership and committee assignments in January.

It is now projected Democrats will control the House of Representatives by a substantial margin–at least 258-177–with the gap likely to widen as more results come in. Likewise, the Senate in the 120th Congress will have at least 54 Democratic members, and this number could rise to 56 once Alaska and Mississippi, now too close to call, are settled (Democrats lead in both by the slimmest of margins).

This looming reality could profoundly affect health care policy during the lame-duck session at the end of 2026 and at the start of the new Congress in January. Republicans control both the House and Senate until the new Congress is sworn in on Jan. 3, so they could try to pass a partisan reconciliation bill that includes their outstanding legislative and budgetary priorities before ceding power. Reconciliation bills, by their very nature, must follow strict budget rules, so pay-fors are usually part of the equation. Republican members of both the House and Senate have advocated budget savings through price transparency and Medicare site-neutral payment proposals, so if they try to pass a reconciliation bill in the waning hours of the 119th Congress, these ideas may be revived.

Likewise, there are opportunities. The Improving Seniors' Timely Access to Care Act may be a major Medicare Advantage prior authorization reform during the lame-duck session. Elements of rural emergency hospital reform may also be on the table. As the dust settles and Congressional leadership's priorities for the lame-duck session become clearer, we will advocate for MA and Rural Emergency Hospital reform and oppose unduly burdensome policy overhauls. To that end, KHA will meet with members of the Kansas Congressional Delegation in Washington later this month.