A Democratic Senate improves the outlook for Biden health and science priorities, including key nominees

WASHINGTON — The outlook for the White House’s health and science priorities just got a whole lot brighter.

With a Democratic Senate, as the Associated Press projected Saturday night, it will be much easier for President Biden to get nominees confirmed, including whomever he taps to lead the National Institutes of Health. Public health officials like National Institute of Allergy and Infectious Diseases Director Anthony Fauci will face less scrutiny, as Democrats will maintain power over key health committees. And Democrats will be a check on a possible Republican House that might want to clash with Biden over issues like government funding and Medicare.

A Democratic majority will figuratively declaw Sen. Rand Paul, a Kentucky Republican who had been chomping at the bit to gain control of the Senate health committee and use it to press Fauci for information about the coronavirus pandemic. He promised in his victory speech Tuesday night to subpoena documents related to Fauci, to investigate the origins of Covid-19, and to scrutinize research funded by the NIH.

But Paul won’t have nearly as much power to cause headaches for Fauci and the White House under a Democratic majority. He won’t have subpoena power and he won’t have the authority to call hearings with public health officials.

Democrats’ win will also make it easier to confirm a potential NIH director. Republicans are broadly skeptical of the agency, and critics are frustrated with the agency’s glacial pace following fast advances on Covid-19. A new director would be tasked with settling debates over whether to focus on basic science, or more instant-impact development projects.

But even with a similar slim majority in the Senate, a few things will be different this time around. It’s highly unlikely Democrats will be able to repeat their historic accomplishments on health care last Congress, from billions in pandemic relief funding, to the largest drug pricing reform in 20 years, to getting a slate of nominees in place to lead the Biden administration’s health care bureaucracy.

If Democrats lose the House, it means that they would no longer have the option to pass partisan legislation, and they would need to negotiate much more closely with Republicans to get much of anything accomplished. That means that there likely won’t be any pie-in-the-sky dreaming about health care policy that Democrats can’t get Republicans on board with.

That still opens the doors for some bipartisan cooperation, however. Policy issues on telehealth access, mental health, insulin affordability, reform of the role of pharmacy benefit managers, and pandemic preparedness legislation have been bipartisan priorities during the most recent Congress.

But even bipartisan agreements will be harder to reach than last year, as a couple long-serving Republican champions of public health issues and science will be leaving.

Sen. Richard Burr (R-N.C.), who led his caucus on pandemic preparedness issues, and Sen. Roy Blunt (R-Mo.), who promoted funding for the National Institutes of Health, also supported President Biden’s nominee for Food and Drug Administration Commissioner, Robert Califf, in a tight confirmation battle earlier this year. Both will be retiring in January.

Burr’s legacy bill, the Pandemic and All-Hazards Preparedness Act, which created an infrastructure and regulatory authorities to quickly respond to public health threats, is up for reauthorization next year, and it’s unclear how willing a House Republican caucus more hostile to funding public health priorities will be to renewing the policy.

House Republicans have also floated Medicare reforms as part of a potential standoff over government spending, but even if they take control of the House, having a Democratic Senate would make it much harder to get policies cutting benefits to seniors signed into law.