Senate*** House**** Governors*****

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1 House and Senate Results As a result of the 2018 elections, Democrats now control the House and Republicans have expanded their Senate majority. Although several races are still undecided, it is expected that Democrats will pick up several seats in the House. Access to healthcare was a significant factor for voters this election, and the results have implications for HIV, hepatitis, and the Affordable Care Act (ACA). Senate*** House**** Governors***** Party Pre-election Post-election Republican Democrat Independent 2* 2** Republican Democrat Independent 0 0 Republican Democrat Independent 1 0 * Angus King (ME) and Bernie Sanders (VT) caucused with the Democrats. ** Bernie Sanders (VT) and Angus King (ME) will continue to caucus with the Democrats us. *** 2 races which have not been called **** 10 races have not been called ***** 2 races have not been called Leadership Races Democrats will hold leadership elections on November 28. Minority Leader Nancy Pelosi (D-CA-12) has already said she intends to run for Speaker of the House. Multiple Democrats have expressed interest in leadership as well, including Steny Hoyer (D-MD- 5), James E. Clyburn (D-SC-6), and Tim Ryan (D-OH-13). The position of Democratic Caucus Chair is also guaranteed to be open, since representative Joseph Crowley (D-NY- 14) lost his primary. Republicans will hold leadership elections on Wednesday, November 14. Speaker Paul Ryan (R-WI-1) will retire at the end of the 115 th Congress, so Republicans will also have to elect new leadership. Majority Leader Kevin McCarthy (R-CA-23), Patrick McHenry (R- NC-10) and Majority Whip Steve Scalise (R-LA-1) are all expected to run for Republican leadership positions.

2 Committee Leadership and Membership While control of the House has flipped, leadership for the House Ways and Means Committee is unlikely to change for either Republicans or Democrats. Since both won their races, Richard Neal (D-MA-1) will become Chair and Kevin Brady (R-TX-8) will become Ranking Member. Leadership for the House Appropriations Committee will change as a result of Rodney P. Frelinghuysen retiring (R-NJ-11). Nita Lowey (D-NY-17) will take the Chair position in the new Congress. Robert Aderholt (R-AL-4), Kay Granger (R-TX-12), Tom Graves (R-GA-14), and Tom Cole (R-OK-4) are vying for Ranking Member. Many of the Committees impacting HIV and hepatitis funding and public health programs will see changes due to retirements and losses. There will be many new Members that will need educating, particularly on Committees of jurisdiction. Some outgoing Members were HIV and hepatitis supporters and bill sponsors. NASTAD will be reaching out to the new Members to provide them with information on our legislative priorities and cultivating champions. House Committees The House Appropriations Committee lost the following Members: Lost election: John Abney Culberson (R-TX-7), Kevin Yoder (R-KS-3), David Young (R-IA-3), Scott Taylor (R-VA-2) Retired: Rodney P Frelinghuysen (R-NJ-11), Tom J Rooney (R-FL-17), Charlie Dent (R-PA-15) Other: Evan H. Jenkins (R-WV-3) lost Senate primary The House Appropriations Committee annually writes the legislation that allocates federal funds to government agencies, departments and organizations. Twelve subcommittees are tasked with drafting legislation to allocate funds to government agencies within their jurisdictions. The House Subcommittee on Departments of Labor, Health and Human Services, and Education, and Related Agencies (Labor-HHS) has jurisdiction over the U.S. Department of Health and Human Services (HHS). This includes the Health Resources and Services Administration (HRSA), which oversees the Ryan White Program, and the Centers for Disease Control and Prevention (CDC), which oversee HIV and hepatitis prevention. The House Budget Committee lost the following Members: Lost election: Dave Brat (R-VA-7), John Raso (R-NY-19), Jason Lewis (R-MI-2) Other: Diane Black (R-TN-6) lost primary for Governor, Jim Renacci (R-OH-16) lost Senate election, Mark Sanford, (R-SC-1) lost primary, Michelle Lujan Grisham (D- NM-1) successfully ran for Governor of New Mexico

3 The House Budget Committee is responsible for drafting Congress' annual budget resolution and monitoring action on the budget for the Federal government. The House Energy and Commerce Committee lost the following Members: Lost election: Leonard Lance (R-NJ-7) (previous Hepatitis champion) Retired: Ryan Costello (R-PA-6), Gene Green (D-TX-29), Joe Barton (R-TX-6), Greg Harper (R-MS-3) Other: Kevin Cramer (R-ND-At-large) and Marsha Blackburn (R-TN-7) ran for Senate and won The House Energy and Commerce Committee has authorizing jurisdiction over the Departments of Energy, HHS, Commerce and Transportation, as well as the Environmental Protection Agency, the Federal Trade Commission, FDA and the Federal Communications Commission. The Subcommittee on Health oversees HHS, National Institutes of Health (NIH), CDC, HRSA, Indian Health Service, Substance Abuse and Mental Health Services Administration (SAMHSA), Medicare, and Medicaid. The Energy and Commerce Committee directly oversees the authorization of the Ryan White Program. Its Senate counterpart is the Committee on Health, Education, Labor and Pensions (HELP). Senate Committees The Senate Appropriations Committee lost the following Members: Other: Cindy Hyde-Smith (R-MS) will be entering a run-off race that she is expected to win. Like its House counterpart, the Senate Appropriations Committee annually writes the legislation that allocates federal funds to the numerous government agencies, departments and organizations. Twelve subcommittees are tasked with drafting legislation to allocate funds to government agencies within their jurisdictions. The Senate Subcommittee on Labor-HHS has jurisdiction over HHS, including HRSA, which oversees the Ryan White Program and CDC, which oversees HIV and viral hepatitis prevention. The Senate Budget Committee lost the following Member: Retired: Bob Corker (R-TN) The Senate Budget Committee is responsible for drafting Congress' annual budget resolution and monitoring action on the budget for the federal government.

4 The Senate HELP Committee lost the following Member: Retired: Orrin Hatch (R-UT) The HELP Committee s jurisdiction covers most of the agencies, institutes and programs of HHS, including the FDA, CDC, HRSA, NIH, SAMHSA and the Agency for Healthcare Research and Quality. This means that HELP Committee directly oversees The Ryan White Program and is responsible for its reauthorization. Its House counterpart is the Energy and Commerce Committee It is important to note that several Democrats and Republicans who have championed HIV and hepatitis issues in the past remain in Congress. Most notable in the House are Barbara Lee (D-CA-13) and Chris Smith (R-NJ-4). Senate champions include Bill Cassidy (R-LA), Cory Booker (D-NJ), and Elizabeth Warren (D-MA). Governors Thirty-six states held gubernatorial elections. Of the thirty-six states, seven states went from Republican to Democratic leadership. No states flipped from Democratic to Republican. Governor* Party Pre-election Post-election Republican Democrat Independent 1 0 *Races have not been called in Georgia or Florida. Medicaid Medicaid expansion was on the ballot in four states: Idaho, Nebraska, Utah, and Montana. The ballots were successful in Idaho, Nebraska, and Utah. Montana, which currently has expanded Medicaid, has rejected the measure to continue their Medicaid expansion, however their legislature may take up the initiative. This makes a total of 35 states, including DC, with expanded Medicaid. Democratic Gubernatorial victories in Maine, Kansas, and Wisconsin may also lead to expanded Medicaid in those states. State Legislatures As a result of the 2018 elections, seven state legislative chambers changed partisan control. Six chambers flipped to Democratic control, and one flipped to Republican control. Republicans now control a total of 62 state legislative chambers (32 senate, 30 house), and Democrats control 37 (18 senate, 19 house).

5 NASTAD will be reaching out to the new Members of Congress and providing them with information on our legislative agenda. NASTAD also encourages you to reach out to new Members once they are sworn-in in January by introducing your jurisdiction s programs and offering yourself as a resource. Please contact the PLA team with any questions.