CounselorsEmpowerACA Government Affairs Blog

The ACA Government Affairs team strives to keep the counseling community connected with important legislative news, updates, and announcements that affect the profession. Questions? Want to get involved in our advocacy efforts? Email us at 


Oct 31, 2018

Healthcare Is On The Ballot November 6. So Are Many Other Important Issues.

The November elections are just days away and mental healthcare for all Americans could hang in the balance. Healthcare has been one of the top issues during this campaign cycle across the country, particularly the provision that includes coverage for preexisting conditions.

Healthcare will likely be addressed in the next Congress that convenes in January. The future of the Affordable Care Act (also known as Obamacare) has been a major issue with many candidates. Before the Affordable Care Act took effect in 2014, 38 percent of non-group plans did not offer mental health care.  Since then, the Affordable Care Act has required non-group plans to cover mental health and substance use disorder (SUD) benefits comparable to those offered in employer group plans, as well as requiring coverage for preexisting conditions.  

On November 6 professional counselors have the opportunity to vote on who will best represent their interests and the interests of their clients on mental healthcare and other policy areas. 

Polls indicate that the Republicans have five chances in six of maintaining the majority in the Senate, and that the Democrats have six chances in seven of gaining the majority in the House.  Historically the party not in the White House makes significant gains in the House in midterm elections.  The historical record in the Senate is more mixed. This year 26 of the 35 Senate seats up for election are held by Democrats so they face longer odds of adding seats.

House and Senate Races

The closest Senate races are in Nevada, Missouri, Florida, Arizona, North Dakota, and Indiana according to polling analysis.  The most likely outcome seems to be the Republicans maintaining their 51-49 vote majority or picking up one more seat.  Forecasting the outcome in the House is more difficult because there are 435 seats to look at rather than 35 in the Senate, and polling and other information is scarcer.  At this point the most likely outcome in the House would be for Democrats to end up with about 230 members versus the Republicans 205. 


Governorships also play an important role in healthcare, including Medicaid expansion and administration, insurer oversight, licensure board supervision, and bans on conversion therapy.  Governors will also play a key role in redistricting decisions following the 2020 census. Wisconsin, Georgia, Ohio, Nevada, Kansas, and Alaska have very competitive races this year.

Polling is not an exact science, and polls come with a margin of error so they should not be viewed as specific predictions. There are always upsets. That is why every vote and every voter matters. ACA encourages every member to get to the polls Tuesday and cast your ballot. 

You can find more information on issues important to counselors in the ACA Election Tool Kit. You can also find House, Senate, and governor predictions and polling analysis at the Cook Political Report and Five-Thirty-Eight.   


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