Millions of Americans went to the polls on Tuesday, feeling anxious about the economy and health care reform, and yielding election results that gave Republicans control of the House of Representatives and weakened the Democratic majority in the Senate. Republicans picked up at least 60 House seats and at least six Senate seats in the election, removing Democrat Nancy Pelosi from her powerful position as speaker of the House and putting Republicans in charge of House leadership and committees.

The Republican sweep extended from coast to coast and removed more than 30 Democratic incumbents from the House of Representatives, including Armed Services Committee Chairman Ike Skelton, Budget Committee Chairman John Spratt and Transportation Committee Chairman James Oberstar.

Exit polling shows more than eight in 10 voters feel the economy is the No. 1 issue facing the nation, and three times as many people believe it is getting worse rather than better. Health care reform followed as the second-most important issue for voters during this election cycle. Nearly three in four voters expressed dissatisfaction with Congress and six in 10 say they believe the country is headed in the wrong direction.

With the midterm elections close to complete, we encourage you and others to see how health care reform affected congressional races by visiting the updated Health Action Network.

Health Care Reform

How the Election Results Affect the Future of Health Care Reform: With the new Republican majority in the House, a stronger showing in the Senate and greater numbers of GOP governors, the health care debate is expected to focus on implementation of the law, as well as efforts to repeal it. While full repeal will face a presidential veto, lawmakers will most likely pursue incremental changes, “tinkering and tweaking” the law to keep the debate top of mind for voters leading up to the 2012 elections.

According to political strategists, Republicans could also use the oversight authority of Congress to slow down or block regulations, essentially stalling the law’s progress. Congressional hearings are likely to focus on the impact of the immediate reforms on costs and coverage, the outlook for reforms that take effect in 2014 and stronger direct oversight of federal regulators. Additionally, the annual appropriations process is likely to serve as a battleground for health care reform issues, with a focus on funding for federal agencies involved in the implementation process.

Two More States Vote to Reject Health Insurance Mandate: At the polls this week, voters in Oklahoma and Arizona resoundingly supported ballot initiatives to opt out of the federal health care reform law. Missouri voters approved a similar measure, Proposition C, with 71% support on a primary ballot in August. A similar proposal on Tuesday’s ballot in Colorado would have prohibited the state from forcing residents to buy public or private health insurance. However, the measure was rejected by a narrow margin.

Public Opinion
Exit Polls Show Half of Americans Still Want Repeal: According to the Pew Research Center, voters were divided over whether to repeal health care reform (48%) or maintain or even expand it (47%) in exit polls on Tuesday. However, the major priorities for 2011 include reducing the deficit, creating jobs and boosting the economy.

Looking Ahead
President Barack Obama has invited the Republican and Democratic leaders of Congress to the White House on November 18 to discuss the new political landscape and ways to work together in the future. The meeting with Rep. John Boehner, Senate Minority Leader. Mitch McConnell, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid is expected to take place during the first week of Congress’ “lame-duck session,” which begins on November 15.

The health care reform bills being debated in Congress threaten to shut out millions of immigrants. But Congress’ exclusionary policies toward immigrants will not simply leave immigrants worse off. They will inevitably jeopardize the nation’s economy and the health of all of us.

President Obama has prioritized health care reform to ensure that millions of Americans have a fair, affordable and efficient health care system. For immigrants, this vision is far from a reality. First, the current health care reform bill treats legal immigrants unfairly. Individuals who have waited years to come to the United States will be required to wait years in order to obtain affordable health care.

Immigrants are generally younger and healthier than the U.S. population at large. However, no one is immune to falling ill or having an accident. The current health care bill would require recently arrived, legal immigrants to wait five years to obtain the only option for affordable health care coverage, Medicaid. While low-income citizens will have access to Medicaid, the most vulnerable among us will continue to wait for affordable health care despite the fact that they pay taxes for the very programs from which they are excluded. There is no sound reason for Congress to discriminate against these individuals and prevent them from receiving basic medical care.

Congress and the White House also took an unprecedented step to prohibit individuals from buying — with their own hard-earned money — an American good that could help their families. The Senate version of the health care bill forbids undocumented immigrants from purchasing private insurance at full cost in the newly created insurance marketplaces. As a result, undocumented immigrants as well as their family members, who are often U.S. citizens or legal immigrants, will likely remain uninsured and will be forced to seek care in the emergency room.

The costs of providing health care for undocumented immigrants will not disappear after passing health care reform. It is unlikely that millions of immigrants, whose contributions keep up our standard of living and our economy functioning, will be deported. Instead, the cost of care will become the financial responsibility of the patient, the provider, the local and state governments, and every single taxpayer. Moreover, in order to exclude a few, there will be additional forms, documents, and bureaucrats that the rest of us will be subjected to. Buying the mandated health insurance could feel like a trip to the Department of Motor Vehicles. Taxpayers will have to pay millions for this additional red tape and delay, all to keep a few people from buying health insurance with their own money.

Providers, employers, consumers, religious leaders, and state and local governments recognize that these policies are short-sighted and will cost all of us more in the long-run. Policies that attempt to exclude and ostracize immigrants also disproportionately harm all communities of color and immigrant-rich states like California and New York, further widening existing inequities in our nation. Yet because immigrants live in all 50 states, the intended and unintended consequences and costs of these restrictions will be far-reaching.

Ending discriminatory and exclusionary policies in this final round of negotiations is not only a matter of fundamental fairness and sound economics. It is required in order to not leave all of us worse off. Congress has a short window of opportunity to remove the restrictions on legal and undocumented immigrants in the health care reform bill. Doing so will not jeopardize the passage of the bill. Failing to doing so, however, will leave all of us, immigrant or not, worse off and wondering what happened to the promise of health care reform.