What US midterm elections mean for climate policy and public health

On 8 November, US voters will decide whether Democrats maintain their slim majority in both houses of Congress. This, in turn, will determine whether the administration of President Joe Biden will be able to pursue its agenda for the next two years. The midterm election – which takes place halfway through each presidential term – is also set to change the balance of power in state governments, with races in every state legislature and 36 gubernatorial elections.

Here is how the election results could affect three key scientific issues: climate change, reproductive healthcare and covid-19 policy.

Climate change

The Inflation Reduction Act passed by Congress in August of this year represented the first serious climate legislation from the federal government and has been a key achievement trumpeted by Democrats in midterm debates. The more than $300 billion it puts towards climate and energy initiatives will accelerate the race to decarbonise in the US and elsewhere, with measures in the bill projected to reduce US greenhouse gas emissions by as much as 44 per cent below 2005 levels by 2030.

That is now the law, but control of Congress will shape how it is implemented, says Corey Schrodt at the Niskanen Center, a right-leaning think tank based in Washington DC that advocates for environmental policy. Democratic control of Congress would give the Biden administration a freer hand to push for clean energy and other projects supported by the bill, as well as climate priorities, on the international stage. A Republican majority in either house could complicate things. “That policy becomes the focus of efforts to repeal, eliminate and investigate,” Schrodt says.

If Republicans gain control of both houses of Congress, they would have a legislative path to repeal the law through a process called budget reconciliation, but Schrodt says that would be unlikely. “It is still a difficult path and industries may react poorly to a repeal,” he says. He also says he has seen “nuggets” of climate-related proposals in Republican platforms related to things like faster permitting to mine the minerals critical to batteries and renewable energy. “I don’t think if there is a Republican majority it will completely be the end of climate action,” he says.

A proposal from West Virginia Senator Joe Manchin to speed up permitting for energy projects, including the transmission lines necessary to decarbonise the grid, was scrapped in September in the face of opposition from both Republicans and progressive Democrats. Permitting reform has since become an urgent issue for Democrats concerned that a Republican-controlled Congress would speed fossil fuel development more than clean energy projects. State elections will also affect interstate transmission line projects, among other clean energy and climate priorities.

Access to abortion

The 2022 midterms will be the first US election in 50 years in which access to abortion is not a right guaranteed by the Constitution.

The issue shot to the centre of US politics in June when the US Supreme Court overturned Roe v. Wade – the landmark 1973 case that guaranteed a woman’s right to an abortion prior to viability of the fetus. In Dobbs v. Jackson Women’s Health Organization, the court’s conservative majority argued that abortion is not a right guaranteed by the Constitution, thus leaving the issue to state governments or Congress to decide.

In the months since that decision, there have already been signs that doctors are delaying lifesaving care for women due to concerns about legal prosecution, and medical organisations such as the American College of Obstetricians and Gynecologists remain emphatic that “abortion is an essential component of comprehensive evidence-based health care”.

Since the Dobbs decision, Democrats in Congress have tried to pass legislation that would guarantee abortion rights in all states; two such bills passed the House but didn’t have the votes to make it to the Senate. Some Republicans in Congress have pushed for nationwide restrictions on abortion, such as a bill introduced by South Carolina Senator Lindsey Graham that would ban most abortions after 15 weeks of pregnancy. Other Republican leaders have said decisions about abortion access should be left up to the states.

States have already made changes. Thirteen states now ban abortions in most cases. Five states have passed laws to ban abortions beyond a certain gestational limit. Ten states have bans or more restrictive laws that have been blocked by courts as legal challenges play out.

“Battles to protect access to abortion and all reproductive healthcare have been and will continue to be fought at the state level,” says Elizabeth Nash, at the Guttmacher Institute, a reproductive health research and advocacy group.

Beyond the races, California, Michigan and Vermont have measures on the ballot to protect the right to abortion and support people seeking abortions from out of state. Voters in Kentucky (where abortion is already banned in all cases) and Montana (where a ban on abortion after 20 weeks was blocked by state courts) will decide on additional anti-abortion measures.

A recent study found the number of abortions increased by 11 per cent after the Dobbs decision in states with few restrictions on abortion procedures, suggesting people are travelling between states to access care. The number of abortions nationwide decreased by 6 per cent.

Covid-19

More than a million Americans have died from covid-19, millions more have symptoms of long covid and the virus continues to kill more than 300 people a day in the US, according to data compiled by The New York Times. What’s more, a soup of new variants is expected to drive a wave of new infections in the weeks ahead.

Despite its ongoing impact, the pandemic has played much less of a role in midterm politics than it did in the 2020 elections. Democrats haven’t centred on the issue. And Republicans have focused more on grievances about past closures and mandates.

Still, the outcome of the election will decide who is in power during the third winter of covid-19, which could see cases increase with new variants and lowered restrictions, not to mention the impact of an ongoing surge of respiratory syncytial virus cases in the US and the possibility of a “twindemic” with flu. Who is in power could also shape funding priorities for health agencies, vaccination initiatives, testing and other health measures. Republican control of Congress may also mean investigations related to the origins of the virus as well as the federal response to the pandemic during the Biden administration, according to reporting by STAT.

There is evidence that Republican-voting counties see more covid-19 deaths than majority Democratic-voting ones, mostly due to different attitudes around vaccination and other mitigation efforts. If the federal public health emergency declared in 2020 ends in 2023 – which Politico reports is the working assumption in the White House – it would leave more decisions about how to manage covid-19 to the governors and state legislatures elected on 8 November.