The U.S. Senate will control who the next president appoints to oversee administration of Affordable Care Act programs and Medicare programs — and anything could happen to control of the Senate in the upcoming general elections.

Helmut Norpoth, a political science professor at Stony Brook University in Stony Brook, New York, says Republican nominee Donald Trump has an 87 percent chance of winning the presidential election in November, because his victories in the presidential primaries were so strong. Most other forecasters, however, say Democratic nominee Hillary Clinton will probably win. Charlie Cook, for example, says Clinton was doing so well in polls in mid-August that it looked as if she already had attracted enough electoral college votes to win. 

Cook and most other well-known forecasters also agree on the most likely outcome of the U.S. House races: They think Republicans will keep control of the House.

The forecasters say they are not as comfortable predicting what will happen to the Senate. The Senate now has 54 Republican senators, 44 Democrats, and two independents who usually vote with the Democrats. Cook says that he thinks the Republicans could keep control of the Senate, but that they could end up with a 50-50 tie with the Democrats. Larry Sabato’s team at the University of Virginia has posted an analysis suggesting that the Republicans could end up controlling anywhere from 47 to 53 seats in the Senate.

The analysts say the Senate races in Florida, Indiana, Nevada, New Hampshire, Ohio and Pennsylvania are especially close.

Many things could happen between now and Nov. 8. Eventful debates, successful campaign ads, hurricanes, or even the Zika outbreak could change how voters vote. 

Related: Florida shudders as Zika spread forces Miami shops to close

If a President Trump ends up getting support from a Republican majority in the House, a narrow Republican majority in the Senate could help him get nominations, or bills, that have some support from moderate Democrats through the Senate.

If Trump comes into office with a Republican majority in the House and the Senate in the hands of Democrats, then he may face the same kinds barriers to getting judges and cabinet secretaries confirmed, and getting even popular, bipartisan, essential bills through Congress, that President Obama now faces. 

Related: 3 reasons Congress could approve an ACA change bill (with video)

If a President Hillary Clinton enters office with Republicans in control of the House, then she may have a hard time getting legislation through Congress no matter which party is control in the Senate. But, if the Republicans are in charge of the Senate, she may have severe problems with getting nominees confirmed, and she may end up having to rely heavily on a combination of temporary, “acting” officials at the top and career civil service workers. 

One possible sign of health insurance industry uncertainty about the Senate races: The political action committees that represent health insurers, insurance agents, insurance brokers and self-insured plans seem to playing only a modest role in supporting the nominees, or likely nominees, in the six hottest Senate races.

The analysis excluded PACs associated with companies that focus mainly on life insurance or property-casualty insurance. We looked at first-quarter filings only for candidates who do not yet have detailed second-quarter contribution data available online.

A review of Federal Election Commission candidate filings for the second quarter reveals that, in Florida, for example, in the second quarter, the only PACs with health insurance ties that contributed to the Senate re-election campaign of Marco Rubio were the Washington,D.C.-based Council of Insurance Agents & Brokers PAC and the Wal-Mart Stores Inc. PAC for Responsible Government.

For a look at what else we saw when we looked at FEC contribution filings for the six closest Senate races, read on:

Murphy, Rubio (Candidate photos)

At press time, Florida had not yet held its congressional primaries. Patrick Murphy, a House Democrat, was the frontrunner on the Democratic side. Marco Rubio, the Republican incumbent, was the leader on the Republican side. (Candidate photos)

1. Florida

Patrick Murphy (Democrat)

$2.4 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
Aon Corp. Political Action Committee Chicago Broker $             2,500
Assurant Inc. Political Action Committee Milwaukee, Wisconsin Former health insurer $             1,000
Blue Shield of California San Francisco Health insurer $             2,000
Florida Health Political Action Committee (The PAC of Blue Cross & Blue Shield of Florida) Washington Health insurer $             1,500
National Association of Insurance and Financial Advisors PAC Falls Church, Virginia Agents and brokers $             2,500
National Association of Health Underwriters PAC Washington Agents and brokers $             2,000
National Association of Health Underwriters PAC Washington Agents and brokers $             3,000
 HEALTH INSURANCE PAC TOTAL    $           14,500
 

Marco Rubio (Republican)

$2.2 million in total receipts  

Contributing health insurance PAC PAC location Description  Amount 
Council of Insurance Agents and Brokers PAC Washington Agents and brokers $             4,000
Wal-Mart Stores Inc. PAC for Responsible Government Bentonville, Arkansas Insurance distributor; benefits buyer $             5,000
 HEALTH INSURANCE PAC TOTAL    $             9,000

 

Related: Zika may infect Florida senate race as money to fight virus lags

Bayh, Young (Candidate photos)

Evan Bayh, a former Democratic Indiana senator, is running against Todd Young, a Republican, for a seat opened up by the retirement of Dan Coats, a Republican. (Candidate photos)

2. Indiana

Evan Bayh (Democrat)

$201,252 in total receipts  

Contributing health insurance PAC PAC location Description  Amount 
None      $                    -
    

Todd Young (Republican

$752,850 in total receipts  

Contributing health insurance PAC PAC location Description  Amount 
July report not available    $                    -
Based on first-quarter data. Second-quarter PAC contributions not available.

 

Related: Health Insurers Plan To Be Active and Senate Rejects Health Bill Pay Cap Amendment

Masto, Heck (Candidate photos)

Catherine Cortez Masto, Nevada’s Democratic attorney general, is running against Joe Heck, a Republican House member, for the seat opened up by the retirement of Harry Reid, a Democrat. (Candidate photos)

3. Nevada

Catherine Cortez Masto (Democrat)

$1.7 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
None   $                    -
 

Joe Heck (Republican)

$1.2 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
Council of Insurance Agents and Brokers PAC Washington Agents and brokers $             2,500
National Association of Health Underwriters PAC Washington Agents and Brokers $             1,000
National Association of Health Underwriters PAC Washington Agents and brokers $             2,000
HEALTH INSURANCE PAC TOTAL   $             5,500

Related: Do Republicans have a shot at winning Harry Reid’s Nevada Senate seat?

Ayotte, Hassan (Candidate photos)

Maggie Hassan, New Hampshire’s Democratic governor, is running against Kelly Ayotte, an incumbent Republican who serves on the Senate Budget Committee. (Candidate photos)

4. New Hampshire

Maggie Hassan (Democrat)

$3.2 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
None   $                    -
       

Kelly Ayotte (Republican)

$2.5 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
Council of Insurance Agents and Brokers PAC Washington Agents and brokers $             4,000
InsurPac (Independent Insurance Agents & Brokers of America PAC) Washington Agents and brokers $             2,000
Wal-Mart Stores Inc. PAC for Responsible Government Bentonville, Arkansas Insurance distributor; benefits buyer $               500
Wal-Mart Stores Inc. PAC for Responsible Government Bentonville, Arkansas Insurance distributor; benefits buyer $            2,500
Wal-Mart Stores Inc. PAC for Responsible Government Bentonville, Arkansas Insurance distributor; benefits buyer $               500
HEALTH INSURANCE PAC TOTAL   $             9,500

Related: Principle plays second fiddle to politics and NH insurance commissioner reappointed

Strickland, Portman (Candidate photos)

A former Democratic governor, Ted Strickland, is going up against Rob Portman, a Republican who chairs the Senate Homeland Security and Governmental Affairs investigations subcommittee. (Candidate photos)

5. Ohio

Ted Strickland (Democrat)

$1.9 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
None     $                    -
 

Rob Portman (Republican)*

$2.9 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
BluePAC (Blue Cross Blue Shield Association PAC) Washington Insurers (Commercial, public, exchange) $            3,500
CareSource Management Services Co. PAC  Dayton, Ohio Insurer (Medicaid) $            1,000
Centene Corp. PAC Clayton, Missouri Insurer (Medicaid, military, commercial, ACA exchange) $            2,500
Health Care Service Corp. Employees’ Political Action Committee Chicago Insurer (Commercial, public, ACA exchange) $            5,000
National Association of Health Underwriters PAC Washington Agents and brokers $            1,000
National Association of Insurance and Financial Advisors PAC Falls Church, Virginia Agents and brokers $            1,000
Unum Group Political Action Committee Chattanooga, Tennessee (Disability insurer) $            1,000
HEALTH INSURANCE PAC TOTAL   $           15,000
* Based on first-quarter data. Second-quarter PAC contributions not available. 

 

Related: Ohio Limits Basic Coverage Rates and McConnell must please Republican base without losing majority

McGinty, Toomey (Candidate photos)

Democrat Katie McGinty is going up against Pat Toomey, a Republican incumbent who serves on the Senate Budget Committee. (Candidate photos)

6. Pennsylvania 

Katie McGinty (Democrat)

$3 million in total receipts

Contributing health insurance PAC PAC location Description
Blue Shield of California PAC San Francisco Insurer (Commercial, public, ACA exchange) $            1,000
Highmark PAC of Highmark Camp Hill, Pennsylvania Insurer (Commercial, public, ACA exchange) $            2,500
HEALTH INSURANCE PAC TOTAL   $            3,500
 

Pat Toomey (Republican)

$3.3 million in total receipts

Contributing health insurance PAC PAC location Description  Amount 
America’s Health Insurance Plans PAC Washington Insurers $            5,000
American Association of Preferred Providers Organization PAC Louisville, Kentucky Insurer (Commercial, public, exchange) $            3,500
Anthem Inc. Political Action Committee Indianapolis, Indiana Insurer (Commercial, public, ACA exchange) $            1,000
Cambia Health Solutions Inc. PAC Portland, Oregon Insurer (Commercial, public, ACA exchange) $            1,000
Cambia Health Solutions Inc. PAC Portland, Oregon Insurer (Commercial, public, ACA exchange) $            1,000
Health Care Service Corp. Employees’ Political Action Committee Chicago Insurer (Commercial, public, ACA exchange) $            1,000
Marsh and McLennan Companies Inc. PAC New York Broker $            1,000
Molina Healthcare Inc. PAC Long Beach, California Insurer (Medicaid, ACA exchange) $            1,500
National Association of Health Underwriters PAC Arlington, Virginia Agent and brokers $            1,000
Self Insurance Institute of America Washington Self-insured employer plan $            2,500
HEALTH INSURANCE PAC TOTAL   $          18,500

 

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Democrats seem tepid about the public option

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