The 2022 midterm elections: What happened and how it impacts HIV advocacy

After a very closely contested election, control of both the House and the Senate are still uncertain. What we do know is that Americans all across the country have spoken up in support of reproductive rights and that, while economic concerns are still paramount for many people, the future of our democracy and equal access to health care is a driving force in determining our elections. And, regardless of who is in power in Washington, our fight to end the HIV epidemic continues on, centered on achieving racial and LGBTQ justice.

U.S. Congress

As of Nov. 10, all incumbent Democratic Senators have either won their races or are leading in the current returns. Democrats have picked up one Senate seat in Pennsylvania, where John Fetterman won his election. This victory enables Democrats to potentially lose a Senate seat elsewhere and still retain control of the Senate. We are still awaiting final results in both Nevada and Arizona, and the Senate race in Georgia between incumbent Sen. Raphael Warnock and challenger Herschel Walker is headed to a runoff election on Dec. 6.

Control of the U.S. House of Representatives is still in close contention, with Republicans favored to win the House. There were notable wins for HIV policy champions, including Reps. Abigail Spanberger, Susan Wild and Jahana Hayes who have been strong partners in protecting the 340B drug discount program and supporting substantive increases in HIV funding across the board.

Governorships and State Level Referenda

Incumbent governors were largely successful in their campaigns for reelection. The elections were not particularly close in many states with incumbents running for reelection, including in Michigan, Georgia and Florida. We are still awaiting final gubernatorial results in Arizona, Nevada and Oregon.

History was also made on multiple occasions during Tuesday’s elections, with Wes Moore being elected as the first Black governor of the state of Maryland, and with Maura Healy being elected by the people of Massachusetts as the first openly lesbian governor in U.S. history. Amazingly, the second openly lesbian governor in the U.S. won her election the very next day, as Tina Kotek was declared the winner of the gubernatorial election in Oregon.

State level referenda on protecting reproductive justice and the rights to an abortion were largely successful, even in more conservative states. Kentucky rejected a referendum that would have declared there is no constitutional right to an abortion, and Michigan voters supported a ballot initiative that enshrined the right to an abortion.


It is unlikely that either party would have a considerable majority to enact their full agendas after January 2023. This possibility means party leaders would have to maintain considerable discipline over their caucus with no defections.

With the “red wave” that was predicted to sweep over Congress prior to election day never becoming a reality, the federal funding landscape is looking much more promising for HIV advocates. Without a significant majority in the House and with the strong possibility of a Democratic Senate, the plans of some congressional Republicans to push fiscal year 2023 spending talks well into next year look less likely, and there is a good chance that a FY 2023 appropriations package can be passed before the new Congress is sworn in.

Unfortunately, the type of policy and funding gains we saw in the American Rescue Plan Act and the Inflation Reduction Act will be harder to come by in the next Congress. With Republicans all but certain to control the House, the budget reconciliation technique that Democrats used over the last two years to push their policy agenda without support from their GOP counterparts will become all but impossible in the new Congress. This inability for Democrats to work on their own to pass budget-related legislation will greatly limit their ability to further President Biden’s agenda over the next two years. As a result, there will almost certainly be a lot of legislative gridlock in the 118th Congress.

In spite of the obstacles that will face us in the new Congress, AIDS United will continue to advocate for the types of meaningful and transformative change to our nation’s laws and spending as we always have.

We will push for increased funding for the Ryan White HIV/AIDS Program, the Minority AIDS Initiative and the Housing Opportunities for People with AIDS program. We will fight for the rights of people who use drugs, of people who engage in sex work, and of the LGBTQ+ community. We will work hard to codify federal reproductive rights in light of the persistent attacks against reproductive freedom, and we will also push for the advancement of racial justice through our support for significant funding for the and the passage of the John R. Lewis Voting Rights Advancement Act and the Anti-Racism in Public Health Act.

We maintain our steadfast commitment to advance funding priorities to end the HIV epidemic and to address the intersecting epidemics and barriers that impact people living with and vulnerable to HIV.