2018 Congressional Mid-Term Election Results & Review

The first mid-term elections for President Trump have come and gone, and the outcomes went largely as most observers thought they might: Republicans maintain control of the Senate and House Democrats now control the majority.  Senate Democrats faced an uphill battle having to defend ten seats in states that President Trump won and 26 total seats to defend out of the 34 that were up for re-election.  While House Democrats needed to pick up only 24 seats to gain the majority and surpassed that number on election night.  The implications for national health care public policy in 2019 will be significant in terms of new Committee Chairs, Ranking Members and the change in Majority Party rule in the House.


Overall, the AST and the transplant community faired relatively well in terms of the 2018 Congressional mid-term elections - largely a result of the Society’s bipartisan and bicameral approach to advocacy, which builds champions on both sides of the aisle.  Although transplant champion, Congressman Kevin Yoder, R-KS, lost his bid for re-election, Congressman Frank Pallone, D-NJ, a long-time 20-year friend of the AST and the transplant community, will become the new Chairman of the House Energy & Commerce Committee.  This Committee has primary or shared jurisdiction over a majority of AST public policy priorities.  Additionally, many AST and transplant community friends in Congress (particularly within the House Democratic Congressional California Caucus) will be elevated in 2019, to include: Nancy Pelosi (D-CA), Doris Matsui (D-CA), and Eric Swallwell (D-CA).  The sponsor of the Living Donor Protection Act (LDPA), Congressman Jerrold Nadler (D-NY), is also positioned to become the new Chairman of the House Judiciary Committee - a very influential post. Our Republican lead sponsor of the LDPA legislation, Congresswoman Jaime Herrera Beutler (R-WA), was also re-elected to Congress.

The AST and other transplant community stakeholder organizations are already reaching out to both re-elected Congressional champions as well as newly elected members of the House and Senate that may be in a position to support transplant public policy priorities in 2019.  For instance, defeated Congressman Kevin Yoder’s replacement (Sharice Davids, D-KS) will likely be interested and engaged on transplant issues as a result of Kansas University.  Other changes for transplant in 2019 include House Congressional Organ and Tissue Donation and Transplantation Awareness Caucus Co-Chair Marsha Blackburn (R-TN) being elected to the U.S. Senate, where she will likely continue her leadership and support of organ transplant and donation issues.  Additionally, the other Co-Chair of the donation and transplant Caucus, Ileana Ros-Lehtinen (R-FL), was defeated in her re-elect bid. The AST and the transplant stakeholder community are working together to identify and secure new members for the 2019 Congressional Organ and Tissue Donation and Transplantation Awareness Caucus, as well as discussing collaborative strategies to advance our legislative and regulatory agendas in this next 116th Congress.


Republicans currently hold 51 seats in the Senate following the elections and Democrats hold 47 seats. The Florida Senate race remains undecided and appointed Mississippi Sen. Cindy Hyde-Smith, will head to a runoff on November 27.  Republicans flipped a total of three seats in Missouri, Indiana and North Dakota, while Democrats took Arizona and Nevada away from Republicans. 

The Senate has already voted on their leadership for the next session of Congress, and things remain largely unchanged, especially at the top with Sen. Mitch McConnell (R-K), and Sen. Chuck Schumer (D-NY) voted to lead their respective parties in the Senate.  A complete look at the Senate leadership is as follows:

Senate Republican Leadership

•    Senate Republican Leader: Mitch McConnell (KY)

•    Republican Whip: John Thune (SD)

•    Chair of the Conference: John Barrasso (WY)

•    Policy Chair: Roy Blunt of (MO)

•    Vice Chair of the Conference: Joni Ernst (IA)

•    Chair of the National Republican Senatorial Committee: Todd Young (IN)

Senate Democratic Leadership

•    Senate Democratic Leader: Chuck Schumer (NY)

•    Democratic Whip: Richard Durbin of (IL)

•    Assistant Democratic Leader: Patty Murray (WA)

•    Chair of the Democratic Policy and Communications Committee: Debbie Stabenow (MI)

•    Vice Chair of the Conference: Elizabeth Warren (MA)

•    Vice Chair of the Conference: Mark Warner (VA)

•    Chair of the Steering Committee: Amy Klobuchar (MN)

•    Chair of Outreach: Bernard Sanders (VT)

•    Vice Chair of the Democratic Policy and Communications Committee: Joe Manchin (WV)

•    Senate Democratic Conference Secretary: Tammy Baldwin of Wisconsin

•    Chair of the Democratic Senatorial Campaign Committee: TBD



Sen. Chuck Grassley (R-IA), current chair of the Judiciary Committee, is thinking of taking over the Finance Committee after the retirement of Sen. Orrin Hatch (R-UT), and plans to make a decision shortly about which committee chairmanship he wants to hold next year.  Should Grassley decide to remain on Judiciary other contenders to chair Finance include: Sens. Mike Crapo (R-ID), Pat Roberts (R-KS), and John Cornyn (R-TX).  Other key health care committees of jurisdiction are expected to remain the same with Lamar Alexander (R-TN) chair of the Health, Education, Labor, and Pensions Committee and Patty Murray (D-WA) remaining ranking member.



So far, Democrats have gained 33 seats and will have at least a 21-seat majority in the 116th Congress. The new session of Congress will see an almost unprecedented number of new faces with 104 members of the current Congress not returning for one reason or another.  At last count 28 incumbent Republicans had lost their seats after Election Day and zero incumbent Democrats had lost. 

A list of outgoing Republicans who lost their bid for reelection:

•    Rep. Mike Bishop (R-MI); lost to Democrat Elissa Slotkin

•    Rep. Rod Blum (R-IA); lost to Democrat Abby Finkenauer

•    Rep. David Brat (R-VA); lost to Democrat Abigail Spanberger

•    Rep. Mike Coffman (R-CO); lost to Democrat Jason Crow

•    Rep. Barbara Comstock (R-VA); lost to Democrat Jennifer Wexton

•    Rep. John Culberson (R-TX); lost to Democrat Lizzie Fletcher

•    Rep. Carlos Curbelo (R-FL); lost to Democrat Debbie Mucarsel-Powell

•    Rep. Jeff Denham (R-CA); lost to Democrat Josh Harder

•    Rep. Dan Donovan (R-NY); lost to Democrat Max Rose

•    Rep. John Faso (R-NY); lost to Democrat Antonio Delgado

•    Rep. Karen Handel (R-GA); lost to Democrat Lucy McBath

•    Rep. Randy Hultgren (R-IL); lost to Democrat Lauren Underwood

•    Rep. Steve Knight (R-CA); lost to Democrat Katie Hill

•    Rep. Leonard Lance (R-NJ); lost to Democrat Tom Malinowski

•    Rep. Jason Lewis (R-MN); lost to Democrat Angie Craig

•    Rep. Erik Paulsen (R-MN); lost to Democrat Dean Phillips

•    Rep. Dana Rohrabacher (R-CA); lost to Democrat Harley Rouda

•    Rep. Peter Roskam (R-IL); lost to Democrat Sean Casten

•    Rep. Keith Rothfus (R-PA); lost to Rep. Conor Lamb (D-PA). (District was consolidated after redistricting)

•    Rep. Pete Sessions (R-TX); lost to Democrat Colin Allred

•    Rep. Scott Taylor (R-VA); lost to Democrat Elaine Luria

•    Rep. Claudia Tenney (R-NY); lost to Democrat Anthony Brindisi

•    Rep. Kevin Yoder (R-KS); lost to Democrat Sharice Davids

•    Rep. David Young (R-IA); lost to Democrat Cindy Axne



Current House Minority Leader Nancy Pelosi (D-CA) is expected to become the next Speaker of the House as she is currently running unopposed for the position.  Rep. Steny Hoyer (D-MD) is running for House majority leader unopposed, but Rep. Diana DeGette (D-CO) is challenging Rep. James Clyburn (D-SC) for majority whip.

On the Republican side, Rep. Kevin McCarthy (R-CA), the current majority leader; will face Ohio Rep. Jim Jordan, who is the co-founder of the House Freedom Caucus in the battle for House minority leader.  Rep. Steve Scalise (R-LA), the current majority whip, is running unopposed for the No. 2 position in House Republican leadership.


Appropriations Committee: Current Ranking Member Rep. Nita Lowey (D-NY) is expected to become the new chair of the Committee.  Rep Granger (R-TX), Rep. Tom Cole (R-OK) and Rep. Robert Aderholt (R-AL) are all running for ranking member.  Rosa DeLauro (D-CT) will likely become Labor HHS Subcommittee chair (responsible for funding HHS, NIH, CDC, HRSA, etc.). 

Energy & Commerce Committee: Rep. Frank Pallone (D-NJ) will become the new chairman, and Rep. Greg Walden (R-OR) will move to ranking member.   With respect to the Energy and Commerce Health Subcommittee, Reps. Anna Eshoo (D-CA), Jan Schakowsky (D-IL), and Diana DeGette (D-CO) are all top contenders for chairing subcommittees, but it’s unclear at this point which one will be tapped for the Health Subcommittee.  Rep. Michael Burgess (R-TX) is expected to stay in his leadership position on the Health Subcommittee and become ranking member. 

Ways & Means Committee: Current Ranking Member Rep. Richard Neal (D-MA) is expected to become the new chairman, and Rep. Kevin Brady (R-TX) will remain the Republican leader of the Committee and move to ranking member.  Rep. Mike Thompson (D-CA) is next in line to become the chair of the Health Subcommittee but has not yet declared his intentions.