A Shift in Power: Midterm Results and What They Mean for Hospital Advocacy

The 2026 midterm elections drew intense attention across the country, particularly in Texas, which many observers viewed as a battleground state in this election. After several close runoffs earlier this year, the general election featured a number of contentious races.

Here’s a look at what the results in Texas and Congress may mean for hospital advocacy at the state and federal levels.

Texas Turns a New Page

Texas Democrats won statewide office for the first time in more than 30 years. Gina Hinojosa (D) defeated Gov. Greg Abbott (R), who was seeking a fourth term. In one of the most closely watched races in the country, James Talarico (D) defeated Attorney General Ken Paxton (R) for Texas’ U.S. Senate seat. Every Republican running for statewide executive office this election lost, including incumbents for Comptroller and Lieutenant Governor.

All 150 seats in the Texas House were up for election this year. Before the midterms Republicans held a majority 88-62. Results are still trickling in, but currently Democrats have secured 76 seats, and Republicans have secured 61 with 13 seats still in flux. Republicans will continue to control the Senate with a 19-12 majority. However, with Sen. Sarah Eckhardt and Sen. Nathan Johnson being elected to Comptroller and Attorney General respectively, a special election will be held to fill their seats.

As a result, affordability, particularly healthcare affordability, is likely to be a prominent theme in the upcoming session. Alongside continued interim discussions, Medicaid coverage and financing could become key points of debate in the 90th Legislature as well as liability protections.

Congress Finds New Majority

Texas wasn’t the only state to see a blue wave. Democrats have secured majorities in both the U.S. House and Senate in the 120th Congress, with a few races still to be called. Additionally, after midcycle redistricting for congressional seats, Texas ended with a 24-14 split and Republican majority for their U.S. House seats.

Consequently, healthcare is likely to be a prominent topic in the next Congress. Medicare for All is expected to draw attention, as are efforts to restore the enhanced premium tax credits that expired at the end of 2025 and reversing or delaying many of the roughly $1 trillion in Medicaid cuts in the One Big Beautiful Bill Act. Newly elected members of Congress will be sworn in Jan. 3, 2027.

As THA continues to assess what the results mean for the hospital field at both the state and federal levels, it is also developing a strategy for engaging the transition teams of each key statewide winner. With 10 weeks until the 90th Legislative Session convenes, THA remains committed to elevating the vital work Texas hospitals are doing and to working with legislators to address rising costs and identify solutions that strengthen access to care for all Texans.

Votes are still being counted for various races across the state and country. Check back for updated results.