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House Democratic leader Nancy Pelosi. Photo: Aaron P. Bernstein via Getty Images

Honestly, although Democrats' takeover of the House is the biggest overall headline of the night, its health care implications are pretty modest.

The big picture: The next two years will test the strength of Republicans' alliance with the health care industry, and pharmaceutical companies in particular. "The real test will be, do Republicans vote ‘no’ on this ... when it’s on the floor?" a pharmaceutical lobbyist told Axios after Republicans were largely silent on Trump's latest drug-pricing plan. We're about to find out.

Repealing the ACA is all the way off the table, though it was already an impossibly steep climb even under unified Republican control.

Oversight will be one of Democrats' biggest overall priorities. I see two possibilities for heath care oversight that could stick:

  • The Justice Department's decision to back red states' anti-ACA lawsuit
  • Hearings that take aim at drug companies for their price increases

Drug pricing could, theoretically, be a potential source of bipartisan agreement between Democrats and President Trump, especially now that Trump has endorsed some pretty liberal ideas, like using Europe as a pricing reference.

  • But Democrats' narrow majority in the House, combined with Republicans' expanded majority in the Senate, means that any major legislative priority will still need bipartisan support.

My thought bubble: A Democratic House may leave industry somewhat worse off on those ticky-tacky but big-for-industry priorities that are always floating around, looking for a vehicle.

  • Pharma might have to swallow a more muscular version of the CREATES Act, a bill aimed at bolstering competition from generics. It will need to push hard in the lame-duck session to get its Medicare "donut hole fix," which Democrats will be less inclined to provide once they take power.
  • As insurers and medical-device companies look for delays in their ACA taxes, they might have to fight a little harder (device makers lost a big ally in Rep. Erik Paulsen, who lost his re-election bid), but these are the kinds of things that almost always end up tacked onto bigger bills that already require a lot of horse trading between the House and Senate.
  • They're not impossible, especially with a GOP-controlled Senate.

Go deeper:

Go deeper

Buffett eyes slow U.S. progress, but says "never bet against America"

Warren Buffett in New York City in 2017. Photo: Daniel Zuchnik/WireImage

Warren Buffett called progress in America "slow, uneven and often discouraging," but retained his long-term optimism in the country, in his closely watched annual shareholder letter released Saturday morning.

Why it matters: It breaks months of uncharacteristic silence from the 90-year-old billionaire Berkshire Hathaway CEO — as the fragile economy coped with the pandemic and the U.S. saw a contentious presidential election.

Restaurant software meets the pandemic moment

Illustration: Annelise Capossela/Axios

Food delivery companies have predictably done well during the pandemic. But restaurant software providers are also having a moment as eateries race to handle the avalanche of online orders resulting from severe in-person dining restrictions.

Driving the news: Olo filed last week for an IPO and Toast is rumored to be preparing to do the same very soon.

Bryan Walsh, author of Future
4 hours ago - Technology

How the automation economy can turn human workers into robots

Illustration: Sarah Grillo/Axios

More than outright destroying jobs, automation is changing employment in ways that will weigh on workers.

The big picture: Right now, we should be less worried about robots taking human jobs than people in low-skilled positions being forced to work like robots.