If Republicans take Congress, Biden’s agenda hangs in the balance.

After a decade of elections with health care near the top of voters’ priorities, the largest federal health programs are no longer central to this election. Republicans are not focused on repealing the Affordable Care Act, sometimes called Obamacare, or making major changes to Medicare and Medicaid in the short term. If Republicans take the majority, Mr. Biden plans to rein in his response to the Covid-19 pandemic and much of its spending. As well as expanding access to telemedicine in Medicare and improving price transparency in health care, many Democrats also hope to build on the Trump administration’s initiatives to consider small startups. Without a president big enough to override their more conservative bills or vetoes, Republicans can focus on legislative efforts that at least some Democrats can support.

If Democrats retain control, they may pursue similar, less polarizing issues. Mr. Biden tried unsuccessfully to pass major structural changes to Medicare and Medicaid as part of the inflation-reduction bill, the new law aimed in part to lower the cost of prescription drugs.

– Margot Sanger-Katz

After breaking records in filling vacancies on the federal bench, the Biden administration’s push to reconfigure the courts will be significantly slowed — if not halted entirely — by Republican control of the Senate.

How Times reporters cover politics. Let’s trust our journalists to be independent observers. So while Times employees can vote, they are not allowed to endorse or campaign for candidates or political causes. This includes participating in rallies or demonstrations or donating money to support a movement or raising money for any political candidate or electoral cause.

Sen. Mitch McConnell of Kentucky, the current and future Republican leader, has demonstrated his ability to stymie judicial nominees. “If that happens, Sen. McConnell has made it clear that he’s not too eager to confirm President Biden’s nominees and will do whatever it takes to fill seats until he gets a different president,” former Rep. Russ Feingold said. Democratic senator from Wisconsin and head of the American Constitution Association. “He usually follows through on those statements and threats.”

So far, the Senate has confirmed 84 judges appointed by Mr. Biden, including a Supreme Court justice, 25 appeals court judges and 58 district court judges — the most in a president’s first two years in office. The White House has fostered a focus on underrepresented ethnic groups and diverse candidates, such as attorney general and civil rights advocates.

Even if Republicans make package deals to advance judicial nominees, as they have done in the past, more progressive candidates face tougher challenges in the Republican-controlled Senate. To help stave off the freeze, Mr. Feingold’s organization is asking Senate Democrats to confirm at least 30 more judges before the newly elected Congress takes office.

– Karl Hulz

Mr. Biden has pledged to enact national abortion protections that were overturned when the Supreme Court overturned Roe v. Wade if voters increase the Democratic margin in the Senate. “The only way this will happen is if the American people make it happen,” he said in his public appeal.

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