2026 Midterm Results: Employee Benefits Outlook

Associated Press and network projections as of Nov. 4 show Democrats winning control of both the U.S. House and the U.S. Senate. Democrats are on track to hold at least 54 of 100 Senate seats (up from 47), at least 228 of 435 House seats (up from 203) and at least 27 governorships (up from 23). Two Senate races, three governor races and dozens of House races remain uncalled, so final totals could change before the new Congress convenes in January. For employers, the question is how much of that shift will turn into benefits policy.

 

President Trump can veto legislation, and Senate rules generally require 60 votes to advance most bills, so even a Democratic majority of 54 to 56 seats would need Republican support. Because of those hurdles, major changes will likely depend on government funding negotiations. Funding bills are a source of leverage because Congress must pass them to keep agencies open, which makes them one of the few reliable vehicles for other policy, and a veto of one can mean a shutdown. Recent history shows both outcomes. The Consolidated Appropriations Act of 2026 carried landmark pharmacy benefit manager reforms, while a fall 2025 shutdown fight over enhanced Marketplace premium tax credits ended without an extension.

 

Current federal funding runs through Dec. 11, which makes the lame-duck session the next checkpoint. Lawmakers may extend funding again, which would move the next round of leverage into the new Congress in 2027. The issues below are the ones most likely to ride on those bills or draw new hearings.