When Democrats assume control of both chambers of Congress in January 2027, they’ll serve an American public struggling to afford skyrocketing health insurance costs or facing the imminent loss of health coverage.
On the campaign trail, Democrats proposed restoring the Affordable Care Act’s enhanced subsidies that expired at the end of 2025 and reversing nearly $1 trillion in Medicaid cuts in the tax-and-spending bill passed by congressional Republicans in 2025.
What’s the Status of Medicare for All?
Medicare for All would be a government-funded national health insurance program touted by the likes of Sen. Bernie Sanders and Michigan’s Senator-elect Abdul El-Sayed. It’s a popular concept, with 2 in 3 adults favoring Medicare for All, according to a recent poll from KFF, a health policy nonprofit.
“The growing support for Medicare for All is a sign that voters want politicians to do something on health care affordability,” said Larry Levitt, executive vice president for health policy at KFF.
The Medicare for All Act, introduced in 2025, would cover all Americans at birth for all necessary care, including hospital services, prescription drugs, mental health and substance abuse treatment.
Rep. Pramila Jayapal, D-Washington, the legislation’s chief sponsor, told Punchbowl News she plans to push for a vote on the floor in 2027.
Democrats probably won’t have the votes to pass Medicare for All, Levitt said, but progressives could accelerate congressional debate about the national health insurance proposal, including during the lead-up to the 2028 presidential campaign.
According to KFF’s tracking poll published Oct. 6, public opinion about Medicare for All can change depending on the details. Three in four adults support the idea of guaranteed health insurance as a right, or the elimination of all health insurance premiums.
KFF found favorability falls when consumers learn about potential trade-offs from a national health plan, such as higher taxes, delays in medical tests or treatments and potential threats to Medicare, the federal health program for adults 65 and older. The Congressional Budget Office estimates that the single-payer health system would cost as much as $3 trillion by 2030.
“At the level of a bumper sticker, there’s overwhelming support” for Medicare for All, Levitt said. “But when you dig into the details, people don’t fully understand what Medicare for All will do and can be swayed by messages on both sides.”
Democrats Will Revisit Obamacare and Medicaid Cuts
Democrats also will probably seek to reverse Medicaid cuts and restore the COVID-era enhanced subsidies that made Affordable Care Act health insurance more affordable for millions of Americans.
When the enhanced premium tax credits expired at the end of 2025, ACA enrollees had to pick up a greater share of their overall health insurance bill. Average costs for ACA enrollees who wanted to keep their insurance plans soared 114% in 2026, according to KFF.
Some healthier customers dropped their ACA coverage in 2026, leaving behind fewer enrollees who were sicker and more expensive to insure. That prompted health insurers to hike the cost of ACA health insurance at double-digit rates for 2027 insurance plans.
Millions of Americans on Medicaid, the state-federal health program for low-income families and people with disabilities, are projected to lose coverage when stricter eligibility requirements go into effect in January 2027. Under changes stemming from congressional Republicans’ 2025 legislation, the One Big Beautiful Bill Act, Medicaid enrollees will have to work at least 80 hours a month, go to school, complete job training or volunteer to maintain their health coverage.
Most working-age Americans get health insurance through the workplace, and they’re facing big cost increases, too. Job-based health insurance costs are projected to rise an average of 9.5% in 2027, the fastest clip in two decades, according to consultant AON.
“Voters elected Democrats because they need and they want relief on rising health care costs,” said Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms. “It’s sort of a political imperative for them to focus right out of the gate on health care costs.”
Corlette said she expects that reversing Medicaid cuts and restoring the enhanced premium tax credits for ACA plans “will be high on the priority list” for Congressional Democrats.
In an 84-page memo from a health care working group to House Minority Leader Hakeem Jeffries, House Democrats listed priorities if they took control of the House. The memo, first published by Politico in September, listed priorities such as reversing Medicaid cuts, expanding health insurance coverage and ensuring abortion access.
Jeffries, who is in line to become speaker of the House in 2027, pledged that House Democrats would pass legislation to reverse Medicaid cuts.
“We’re going to fight to reverse these painful Medicaid cuts,” Jeffries said during his victory speech Nov. 4 after polls closed.
In a post-election interview with Fox News, Trump said the “power of veto” is one of the “stronger powers a president has” as he vowed to veto “insane” legislation passed by Democrats.
Levitt also said he expects Trump would probably veto legislation seeking to reverse Medicaid cuts or restore the ACA premium tax credits, but he said Democrats might find common ground with the Republican president on lowering the cost of prescription drugs.
Trump has repeatedly touted his efforts to lower prescription drug prices through “most favored nation” deals negotiated with drug companies. In 2022, the Biden administration-backed “Inflation Reduction Act” empowered Medicare to negotiate prices on a limited number of drugs.
“Democrats and President Trump are not that far apart, at least rhetorically,” on lowering prescription drug prices, Levitt said.
Reporting by Ken Alltucker, USA TODAY / USA TODAY
USA TODAY Network via Reuters Connect
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