Understanding the Impact of the 2024 Federal Elections

Last week's elections ended highly competitive races across the U.S., with some results still undetermined. Come January, Republicans will control the White House for the next four years and Congress for the next two.

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Federal Election Results

Former President Donald Trump defeated Vice President Kamala Harris and will be sworn in as the 47th president on January 20, 2025. In the Senate, Republicans will likely regain a 53-47 majority. In the House, Republicans will likely retain their existing majority, ensuring the party has unified control of government for the first time since 2018.
The new political landscape will have many significant implications for ASHA's advocacy, some of which are known and some of which will become clearer once the new Congress convenes on January 3, 2025. What is certain is that we need you to stay involved and engaged with us as we advocate together for policies that benefit audiologists and speech-language pathologists (SLPs).

Together, we have been able to achieve positive advocacy results regardless of the party controlling the White House and Congress.

Things to Know

ASHA is nonpartisan and works with the administration and members of Congress in both parties to advance our policy priorities. Most of the lead Democratic and Republican sponsors of our key legislation were re-elected, which will facilitate reintroduction of bills in the new Congress if they are not enacted this year. There are some takeaways that will shape the policy and political landscape in the coming months and years as we transition to a new administration and Congress:

• For the Senate, there will be new Republican party and committee leaders who may have differing views on issues impacting audiologists and SLPs than current Democratic leaders.
• In the House of Representatives, Republican and Democratic leadership teams will likely remain mostly the same, though there will be some new committee leaders for both parties resulting from election losses, retirements, party term limits, and members of Congress leaving to serve in the Trump administration.
• There will be new appointed leaders at federal agencies and departments, such as the Department of Health and Human Services and its Centers for Medicare & Medicaid Services, and the Department of Education and its Office of Special Education Programs. President-elect Trump is also likely to rely on informal advisors whose perspectives and opinions he values.
• There are checks and balances built into the system that prevent one party with unified control of the executive and legislative branches of government from acting unilaterally.
• The mid-term congressional elections in 2026 could serve as a referendum on the first two years of President-elect Trump's administration.
• The new administration may use special budget rules to expedite consideration of its agenda, meaning Congress could consider substantive legislation earlier in the year than usual with a simple majority vote to pass in the Senate.
• Republicans will likely also use a process called the Congressional Review Act to fast-track consideration of legislation to repeal previous regulations issued during the Biden administration.
• Republican control of the Senate will facilitate confirmation of President-elect Trump's judicial and executive nominees, which will enable the new administration to shape policy through the regulatory process as well as by passing legislation through Congress.

Federal Issues ASHA Is Watching

ASHA will continue our work to advance our members' priorities as outlined in our 2025 Public Policy Agenda. However, the specifics of how our federal advocacy priorities may be addressed will be determined as the president and majority in Congress decide whether and how to turn political rhetoric and campaign promises into legislative reality. We will keep you informed on any relevant developments on these and other issues important to audiologists and SLPs so you can advocate for yourself, your profession, and your clients, patients, and students as easily, meaningfully, and effectively as possible.

This is how the election results could impact some of the federal policy priorities of interest to audiologists and SLPs; however, much of this is speculation based on traditional policies supported by the Republican party:

• Affordable Care Act (ACA): Although previous attempts to fully repeal the ACA were unsuccessful, Congress may attempt to significantly change key provisions that could impact access to marketplace plans and existing consumer protections that apply to almost all payers (e.g., coverage of pre-existing conditions). Marketplace plans currently include habilitation and rehabilitation as essential health benefits. Examples of possible changes include reducing ACA subsidies or increasing the availability of short-term, limited-duration insurance (STLDI) plans.
• Diversity, Equity, and Inclusion (DEI): Congress could use the annual federal funding process and other legislative vehicles to attempt to eliminate and/or reduce funding for DEI offices and programs across federal agencies.
• Education (K-12): President Trump cannot eliminate the Department of Education through executive action. Currently, there is insufficient support to do that legislatively. But the administration may propose cuts to public education programs while seeking to increase funding for public and private school choice options.
• Education (Higher Education): There may be an effort to revise the role of accrediting agencies with a focus on "outcomes" and "value." Previous efforts in this area have been primarily focused on institutional accreditors, but may also impact programmatic accrediting agencies, such as the Council on Academic Accreditation.
• Funding: The administration and Congress will scrutinize and seek to constrain federal discretionary spending (funding Congress controls annually compared to mandatory spending on programs such as Social Security and Medicare) so we don't expect new investments in programs for newborn hearing screening or for the Individuals with Disabilities Education Act, nor do we anticipate federal grants to diversify the professions.
• Gender-Affirming Care: The congressional majority may seek to limit access to gender-affirming care, which could potentially impact the ability to provide gender-affirming voice therapy.
• Medicaid: There could be a push to add eligibility restrictions, such as work requirements, as a condition of receiving federal Medicaid benefits and to give states the option to apply for block grants that would give states more flexibility but cap federal contributions.
• Medicare:
  • Payments: There is still strong bipartisan support in both the Senate and House to address Medicare provider payment cuts, though the scope of future relief could be narrower than in the past.
  • Telehealth: Both parties in the House and Senate support extending existing authorities and flexibilities that enable audiologists and SLPs to provide telehealth services, though the length of future extensions or decision about whether to make them permanent could be constrained because of cost.
  • Hearing Aids: There will be no serious legislative efforts to add a hearing aid benefit to Medicare, although there is bipartisan support for expanding Medicare coverage of services audiologists provide.
• Student Loan Debt: Congress and the administration may try to undermine previous efforts to provide federal student loan debt relief (both blanket and targeted relief) and to streamline income-driven repayment programs.

Before Year End

The outgoing Congress will hold a "lame duck" session starting on November 12 that likely will run through December 20. During this period, House and Senate party and committee leaders will be chosen, and incoming members will receive a policy and political orientation so they can hit the ground running next year.

A key question is whether President-elect Trump indicates his preference on government funding for the remainder of the fiscal year during the lame duck session, particularly if he encourages lawmakers to wrap up spending by the end of this year or pass another short-term continuing resolution into 2025 to give his new administration and the 119th Congress more leeway over current and future spending levels.

A "lame duck" session happens after an election and before the beginning of the new Congress.

Make an Impact Today

Before the 118th Congress adjourns, we still have bills we're trying to pass. Remember: Any legislation that does not pass before year end must be reintroduced in the 119th Congress.

• TAKE ACTION: Take action now to help influence the outcome of important issues such as stopping Medicare payment cuts and extending Medicare telehealth authority in the lame duck congressional session.
• LEARN MORE: Register for the last webinar of ASHA-PAC's four-part webinar series on the 2024 elections, Election 2024: Post-Election Policy and Political Outlook, which takes place at 7:00 p.m. (ET) on Tuesday, December 17. The webinar will provide a more detailed look at potential political and policy implications of the elections for audiologists and SLPs.
• BE INFORMED: Sign up to receive the ASHA Advocate, via ASHA Headlines, for the latest advocacy news and information.
• REVIEW the 2025 Public Policy Agenda to see next year's advocacy priorities for audiologists and SLPs.

Questions?

For questions about federal elections and legislation, contact Jerry White, ASHA's senior director for federal and political affairs, at [email protected].

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