Every presidential election is historic and monumental. However, the 2024 election clearly stands out as momentous in a far greater way. Polling leading up to the election showed an evenly tied race between a polarizing former president and the sitting vice president in an administration that has seen its popularity gradually decline. While we are still waiting for many crucial election results, we do know a lot.  

President:

Former President Trump won a decisive electoral victory over Vice President Kamala Harris. Trump is on pace to win all seven “battleground” swing states while not losing a single state that he won in 2020. His margin of victory in those swing states was narrow, but wider than the margins with which President Biden won those states in 2020. Trump also won the popular vote for the first time in his three presidential elections. He will follow President Grover Cleveland as the second president to serve two non-consecutive terms.  

 There are many ways to analyze the electorate. This article will not dive into all of those nuances. However, some clear takeaways are that Trump won by making gains with constituencies that have historically supported Democratic candidates. He did this in both swing states and non-swing states.  

Conversely, Harris did not have a strong voter turnout in the swing states. She had an easier electoral path to victory, only needing to win Pennsylvania, Michigan and Wisconsin to reach the necessary 270 electoral votes to win the election. She largely underperformed compared to Biden’s results in 2020.  

Senate:

As expected, the Senate will flip from Democrat to Republican control. Several incumbent Democrats successfully defended their seats despite Trump’s victory. However, Democrats went into the election with a very slim majority and many unfavorable races. West Virginia’s open Senate seat vacated by the retiring Democratic Senator Joe Manchin was won by Republican Governor Jim Justice. Republican Senate candidates also defeated Ohio Senator Sherrod Brown and Montana Senator Jon Tester. Notably, several victorious Democratic Senate candidates outperformed Harris in their respective states. This will give Republicans at least a two-seat majority in the Senate with several more Senate races yet to be called that could add to their majority.  

Republicans controlling the Senate has hugely important implications for the Trump Administration. The Republican victory in the Senate means it will be much easier for President Trump to confirm his cabinet and judicial nominees. It could also provide an opportunity for Trump to appoint new Supreme Court justices should any vacancies arise during his term. 

Future of the Filibuster:

Of course, control of the Senate means less if a party does not control at least 60 seats. This is because of the Senate’s rule, commonly referred to as the filibuster, that requires at least 60 votes to advance most legislation. Republicans are not expected to have 60 seats and it is highly unlikely they will be able to attract enough Democrats to reach that threshold for most (if not all) of their legislative agenda.  

Senate Republicans will also have a new leader for the first time since Kentucky Senator Mitch McConnell ascended to this role in 2007. McConnell is not running for reelection as Republican Senate Leader. Senate Republicans are scheduled to vote on a new Leader next week. Public support for the filibuster has gradually eroded as it has consistently stood in the way of legislation championed by both parties. Senator McConnell was a staunch defender of the filibuster. It remains to be seen what his successor’s position will be on this important Senate precedent.  

House of Representatives:

As election results continue to come in, control of the House is still undetermined with many races still undecided. All 435 House seats are up for election, and a party needs 218 seats to gain control. At this point, it appears that Republicans have the upper hand over Democrats to win control of the House. While we don’t know the results of many races yet, here’s what we know so far:  

Many districts are still counting votes and are too close to call. Among these, are two incumbent physicians facing tight races for reelection:  

• Iowa 1^st District: Mariannette Miller-Meeks (R) 
• Washington 8^th District: Kim Schrier (D) 

We do know that several healthcare professionals were elected to Congress (what a coincidence that they all represent their respective state’s 3^rd district).  

• South Carolina 3^rd District: Sherri Biggs (R), psychiatric nurse practitioner 
• Utah 3^rd District: Mike Kennedy (R), family medicine doctor 
• Missouri 3^rd District: Bob Onder (R), allergy and asthma doctor 
• Oregon 3^rd District: Maxine Dexter (D), pulmonologist and critical care physician
• Minnesota 3^rd District: Kelly Morrison (D), OB/GYN physician. 

Many health professionals are retiring from Congress, which could leave fewer Congressional allies on key issues such as physician reimbursement and telehealth. It is refreshing to know that some of these allies will be replenished with new healthcare professionals.  

These races, along with many others, will play a critical role in determining which party gains control of the House.  

Budget Reconciliation:

If the House remains under Republican control, this means that Republicans will control the House, Senate and White House. As discussed above in the Senate section, the filibuster could prevent Republicans from advancing their full legislative agenda without Democratic support. However, with control of Congress and the White House (and deciding not to eliminate the filibuster), Republicans would likely rely on the use of a legislative procedure called budget reconciliation.  

Budget reconciliation allows the Senate to pass legislation with a simple majority instead of the 60-vote threshold. Due to neither party’s ability to overcome the filibuster, most recent major legislation was passed using this procedure including the Affordable Care Act, the Tax Cuts and Jobs Act, the American Rescue Plan Act and the Inflation Reduction Act.  

While politically advantaged, reconciliation bills are disadvantaged from a policy standpoint in that they can only include provisions that directly impact federal spending and revenue.  

What’s Next:

Congress returns to the Capitol next week to kick off the “lame duck” session of Congress. Congress has been out of D.C. since September and has not meaningfully addressed most legislative issues since July. We are now in a sprint to the finish line.  

Congress has several important issues to address before the end of the year. These include funding the federal government, extending Medicare telehealth coverage flexibilities, and averting as much as a 9% reduction to Medicare payments to clinicians. Senators and Representatives will also attempt to advance their personal legislative priorities before the end of the year.  

Control of the House will likely dictate how productive Congress is during the lame duck. If Republicans win control of the House, they could punt on addressing key issues such as government funding until early next year as they will have a stronger hand to play with control of Congress and the White House.  

We will speculate further on the lame duck and policy priorities for 2025 in a future edition of Capitol Insights.  

A final reflection:

I cannot prevent myself from dwelling on key moments that shaped history. One of these moments I am drawn to is President Lyndon B. Johnson’s successful run for the Senate in 1948. He came incredibly close to losing that election, which he saw as his final chance to advance beyond his role as a congressman. Readers of Means of Ascent will recall how Johnson stole his victory by bribing corrupt local party leaders to deliver the necessary votes he needed to defeat his opponent, Governor Coke Stevenson – an immensely popular governor who won every county in the state during his last gubernatorial election.  

This practice of “buying” votes was common in Texas politics at the time and both campaigns employed this tactic. In fact, Johnson lost his 1941 Senate race because this tactic was used against him with great effect. Johnson was determined not only to avoid repeating this mistake in 1948 but also to win at any cost. He therefor used the corrupt tactics at an unprecedented scale.  

Of course, he was caught. It didn’t take a keen eye to notice that a large number of names were added to the election results for certain precincts that were written in alphabetical order, with identical handwriting, and in a different color ink than the existing results.  

Stevenson took Johnson to court and what played out would likely have won an Oscar award if it was a movie.  

There were two simultaneous legal actions that decided the race. One was Stevenson’s case challenging Johnson’s win in Texas. The other was an effort by Johnson’s campaign to have U.S. Supreme Court Justice Hugo Black intervene to pause the case. Stevenson had to win his case against Johnson before the deadline for the ballots to print. Otherwise, they would be printed with Johnson’s name as the Democratic candidate, and it would be too late to change the ballot even if he won his case. At that time, Democrats always won statewide races in Texas.  

Stevenson’s case against Johnson was strong. It submitted the corrupted ballot boxes as evidence. The judge recessed the case right before physically opening a key ballot box from a corrupt precinct that would have clearly shown there were no ballots for the names added to the tally sheet. During that break, Justice Black issued his order to pause the case which handed Johnson his victory. The corrupted ballot box was never opened.  

Johnson went on to win his election to the Senate where he would quickly become its Majority Leader. He completely reshaped the Majority Leader role from a powerless job that nobody wanted to the influential and prominent position it is today. Without winning his Senate election in 1948, he would have never done this and therefore would never have become Vice President and then President where he led the passage of sweeping social reform bills and deepened our involvement in the Vietnam war.  

I can’t help but think about how different things would be if the Texas judge opened that ballot box before Justice Black’s order? The course of history was moments away from something completely different. Johnson’s public service career likely would have ended right there. The confluence of events that led to the result in the legal case challenging his victory was a huge ripple effect on the course of U.S. history.  

Turning now to this election, there were many similar key moments that led us to the result we saw last night. What happened if President Biden did not debate Trump? His disastrous debate performance reshaped the election by leading to Biden’s withdrawal and Harris’ candidacy. Democrats than coalesced around Harris within 24 hours with no serious challenge to her candidacy. Less than a month later, Trump survived an assassination attempt by mere inches.  

Now he is President-elect again and is well positioned to have a successful second term with a strong public mandate and control of at least one Chamber of Congress.  

Last night, a stone was cast into a pond. What ripple effects will it have over the next four years and beyond? When the dust settles on his presidency, I will always look back on what President Trump accomplished with these key moments in mind with an appreciation for the historical uniqueness of the campaign we just experienced.  

One final lesson is to dispel yourself of the notion that vice presidents don’t matter. If there is one thing we learned from LBJ’s story, it’s a reminder that vice presidents can become president under the most unpredictable of circumstances. Vice presidents are almost always future candidates for President e.g., Joe Biden, Mike Pence and Kamala Harris. I will therefore be paying close attention to how J.D. Vance fulfils his duties as Vice President and positions himself for the future.  

In closing, this audience will have different views of the election outcome. Some will be happy, and others will not. Every presidential transition is full of both uncertainty and opportunity. The work we have before us to succeed in the new administration and new Congress is the same regardless of who won the election.