The Doctors Are Running, and the Exam Room Is on the Ballot

A Record Wave in White Coats

Most people file a physician’s run for Congress under biography: a respectable CV, a good bedside manner, a short detour into public life before real politics resumes. That filing is wrong this year. What is happening on the ballot is not a scattering of individual career moves. It is something closer to a migration, and the numbers are large enough to measure. The American College of Gastroenterology has estimated that as many as 25 physicians could win congressional office this election cycle, a record number that would usher in “a new generation of physician-lawmakers”. The direction of travel is not in doubt. In California, the paediatrician Richard Pan is running with three words stretched across the front page of his campaign website: “Public Health Hero”. It is also a precise description of the pitch. Pan is not selling management experience or a tax schedule. He is selling the authority of a medical licence, and asking voters to accept it as collateral.

Most of the physicians already sitting in Congress are Republicans, including all four physicians previously elected to the Senate. Two of those candidates have landed in the highest-profile Senate races of the cycle. Abdul El-Sayed, a physician and former public health official, is locked in a close race for Michigan’s open Senate seat. In South Carolina, the paediatrician Annie Andrews has turned what would normally be a safe Republican Senate seat into a battleground. Below the Senate line, at least five Democratic newcomers with medical degrees are aiming to join the 120th Congress after the November midterm election (elections held halfway through a president’s term). Nurse.org counts at least 10 Democratic nurses making a bid for Congress this year, against four Republicans. The arithmetic matters because the Senate map (the set of Senate races and their likely partisan outcomes) is unforgiving. Democrats need a net gain (seats won minus seats lost) of four seats for the majority, and the roughly ten races that decide the chamber are mostly running neck and neck. On the Republican side, one high-profile physician, Senator Bill Cassidy, is stepping down, while others, including Senator Roger Marshall of Kansas, face uncertain odds for re-election. The doctors are therefore not a curiosity at the edge of the ballot. They sit on the narrow path through it.

Money follows the white coat, and the first question worth asking about any wave is who pays for it. Representative Ami Bera, a California Democrat who is also a doctor, helped form the Democratic Doctors political action committee (PAC) this year to push healthcare up the election agenda. The pro-science advocacy group 314 Action reported in October that it had spent nearly $30m on this year’s midterms. Vax PAC, founded by the epidemiologist Eric Feigl-Ding, backs candidates who support responsible vaccine policies. Feigl-Ding does not frame the surge as an act of partisanship. In his words: “Scientists themselves have woken up. We cannot just abandon the public forum to all of this misinformation, disinformation.” [1] He reaches for a deliberately unheroic image to describe the work: “It’s not like public health is rolling up our sleeves and getting dirty in the pigsty.” Then comes the line that turns a campaign into a strategy: “What public health is doing is immunising ourselves against politics.” [1].

The claim these candidates make is not that medicine is a superior profession. It is that the exam room is the place where costs stop being abstractions. Bera draws the distinction directly: “Let’s not talk about reimbursement. Let’s talk about why we went to medical school — we want to care for our patient.” [1] He goes further: “Doctors who have practised, have been in the exam room, in the OR [operating room] have a unique perspective on patient care. They bring that unique perspective to Congress.” The exam room is offered as a credential no consultant can purchase and no incumbent can inherit. Whether voters accept the exchange is a separate question, and an open one.

One Trillion Dollars and a Measles Count

The macro number that frames every one of these races is the president’s standing. Reuters and Ipsos found in late October that Donald Trump’s approval rating has slumped to 31 %. A president at 31 % is not an asset to his party in a midterm. He is a weather system, and every candidate on the ballot is standing in it. The health numbers sit inside that weather. A Pew Research Center poll on October 8 identified healthcare as the third most important election issue for Americans, behind the economy and the future of US democracy. The partisan split is where the story lives. Eighty-two percent of Democrats ranked healthcare as a very important issue, compared with 53 % of Republicans. A 29-point gap on a single issue tells you which party’s voters are casting a health vote. It is not the party that passed more than $1 trillion in healthcare cuts.

The policy record is specific, and it is where the candidates get their material. As a candidate in 2024, Trump courted voters sceptical of the American healthcare system. Confidence in doctors and public health researchers had been declining since the COVID-19 pandemic, and he tapped that trend by recruiting the vaccine sceptic Robert F Kennedy Jr to his campaign. Kennedy rallied supporters under the banner “Make America Healthy Again”, or MAHA, a variation on Trump’s own slogan. Trump promised to let Kennedy “go wild on health” if he were returned to office. After the election he announced Kennedy as his pick for health and human services secretary. Since the start of Trump’s second term, Kennedy has pushed to minimise federal vaccine guidelines, bucking scientific consensus, and has championed cuts to agencies including the Centers for Disease Control and Prevention and the National Institutes of Health. Trump, meanwhile, rallied Republicans to pass the One Big Beautiful Bill Act last year, which produced more than $1 trillion in cuts to healthcare spending. As part of that bill, Republicans allowed health insurance subsidies to expire. The consequence was higher premiums for millions of Americans. That is the who-pays question answered in a single line item: the subsidy lapses, and the premium arrives in the mailbox.

South Carolina supplies the wave with its sharpest exhibit. An estimated 997 cases of measles were reported in the state between 2025 and 2026. Andrews has pointed to that outbreak as evidence of the failure of Trump’s health policies. Her February column on the outbreak carries the argument in her own words: “We are flirting with the return of an old killer, not because the science changed, not because the virus itself changed, but because our politics did.” She wrote: “At the highest levels of our federal government, we have watched medical expertise get shoved aside while conspiracy theories get promoted.” [1].” The distinction she draws is the one that matters for a vaccine-preventable disease. An outbreak is not a policy opinion, and it cannot be argued down in a hearing. It is a count of cases, and the count is what makes it usable in a campaign.

The Doctors Are Running, and the Exam Room Is on the Ballot (Image 1)

In Michigan, El-Sayed has made a similar move with a far less familiar organism. He has pointed to a recent uptick in cyclospora, a diarrhoea-inducing parasite that can be spread through fresh produce such as lettuce, and has blamed the spread on the federal government’s reduced capacity to inspect food as a result of Trump’s budget cuts. At a campaign stop in September he put it this way: “If you’re kind of tired of dodging lettuce in the United States of America, I think we all could agree we probably need a public health senator right about now.” [1] Cut the inspectors, and the risk migrates to the salad. But the doctors are not a bloc, and their prescriptions diverge. Andrews has called “Medicare for All”, the proposal for universal public healthcare, an “outdated, non-pragmatic policy”. [1]. El-Sayed is a strong proponent of the same policy and co-wrote a book called Medicare for All: A Citizen’s Guide. Two doctors, one diagnosis of an affordability crisis, two different treatments. The United States has one of the costliest healthcare systems of any high-income country in the world, and affordability has been a common feature of many of the Democratic doctors’ campaigns. Andrews has dubbed her agenda the “Patients and Prices Platform” and toured her state under a similarly named banner.

The Word Was Socialism

Matt Motta, a policy expert at Boston University’s School of Public Health, supplies the frame that makes the wave legible. His formulation is compact: “Health has always been political, but health hasn’t always been partisan.” [1] “Our health has become increasingly polarised along partisan lines,” he adds. [1]. The distinction is not academic. A physician can claim to stand outside the loyalty test, at least for the length of one campaign. The claim is not proof of independence. It is a claim, and voters get to price it.

The sequence Motta describes runs through four elections, and each one used health as a weapon. In 1994, Bill Clinton’s administration pushed Congress for healthcare reform, and Republicans framed the effort as “socialism” on the way to flipping both chambers. The passage of the Affordable Care Act in 2010 under Barack Obama gave healthcare a defining role in the midterms that followed. In 2010, Republicans ran against the newly passed law. In 2018, after Trump’s first election, Democrats campaigned against his efforts to roll the Affordable Care Act back. In 2022, restrictions related to the COVID-19 pandemic gave Republicans fuel to attack the Democratic leader of the day, then-President Joe Biden. Across that stretch, healthcare has played a defining role in nearly every midterm following the election of a new president. This cycle adds an entry with a different author.

The governor’s race in Ohio is where the pattern leaves Congress. Amy Acton, the former director of the Ohio Department of Health, won the Democratic primary (an election to choose a party’s candidate) and is running for governor. A recent Marist University poll puts her 7 percentage points ahead of her Republican opponent going into Tuesday’s vote. Feigl-Ding described the result as historic and asked: “If you think about it, how many times in history does a health director run for governor and win the primary, and is now slated to potentially win the governor’s race?” In Michigan, El-Sayed measures the same scarcity from a different angle: “If I were elected, I would be the first Democratic doctor elected to the US Senate in nearly 50 years.” [1].” Bera, watching from inside Congress, thinks the terms of the argument are shifting. He describes the old script in his own words — “Democrats defending the Affordable Care Act, Republicans attacking the ACA” — and argues that the scale of the present crisis has opened the chance to ask about the “what next”. [1] Motta’s reading of this crop is more transactional. The new candidates are “trying to capitalise on how frustrated most people are with these decisions”. [1] Both readings can be true simultaneously. A doctor can be sincere about a patient and still be running on a poll.

In the year leading up to the 1994 midterms, the administration of Bill Clinton pushed Congress for healthcare reform. Republicans, Newt Gingrich prominent among them, framed that effort as “socialism”. The right-wing party flipped both chambers of Congress that year, in a midterm dubbed the “Republican Revolution”. [1] The lesson is that a health argument has been converted into a general-election weapon before, by the party attacking a health plan rather than the party defending one.

Sources

Aljazeera — Quote source (original article)

The Doctors Are Running, and the Exam Room Is on the Ballot (Image 2)