Democrats will face a health care stress test

Democrats will be able to take plenty of messaging votes on health care after their blowout wins Tuesday — but they'll face too many limits and internal disagreements to force all of the big policy changes they want. Why it matters: They'll have a tough time repealing Medicaid cuts or restoring enhanced Affordable Care Act subsidies while President Trump is still in office, and their own divisions will hold them back on other issues. And Medicare for All ? Last night gave the idea a big boost, but don't hold your breath. Friction point: With control of both the Senate and House, Democrats will have powerful new leverage — but that leverage will also expose fault lines. Until now, progressives backing Medicare for All and centrists favoring more incremental changes were united in opposing Trump administration policies and blaming the president and the Republican Congress for the health affordability crisis. They'll try to use their power in the next Congress to promote sweeping changes with an eye toward the 2028 elections while also advancing more piecemeal policies, hoping to force some deals with Republicans. But they'll still face divisions over how to expand the federal government's role in the health system, or how to bend the steep health cost curve. Driving the news: House Democrats have already signaled their opening moves with a 100-hour/100-day agenda agenda that prominently features health policies like reinstating the enhanced ACA tax credits that expired at the end of 2025. There will also be votes to roll back the steep cuts to federal Medicaid spending that Republicans included in their "One Big Beautiful Bill," per an 84-page memo from a health care working group to Democratic Leader Hakeem Jeffries (D-N.Y.). Other near-term agenda items include expanding Medicare drug price negotiations to private insurance, restoring withheld National Institutes of Health research funding and ending the use of AI in authorizing certain services in traditional Medic