The Most Urgent Science, Health and Climate Issues in the 2022 Midterm Elections

Yet again, the stakes going into U.S. Election Day are soberingly high—and the results at all levels of government will have lasting ramifications for millions of human lives on issues ranging from abortion access to the climate emergency.

Democrats have held the presidency and both houses of Congress for two years, taking some of the country’s most ambitious measures to date to combat climate change. At the same time, attention has waned among both Democratic and Republican policymakers when it comes to continuing efforts needed to control the COVID-19 pandemic. And this year, a newly strengthened conservative majority on the Supreme Court has overturned the right to abortion access, setting off legislative battles at the state and potentially federal levels.

Ongoing threats from misinformation and disinformation, as well as a surge in right-wing extremist rhetoric, have made the election even more tense and threaten the durability of U.S. democracy. Here Scientific American examines how the election on November 8 could shape responses to some of the heaviest problems facing the nation, depending on who ends up taking power in Congress and the states.

Abortion rights

The Supreme Court’s controversial decision to overturn Roe v. Wade earlier this year has made abortion rights a central midterm election issue. For women ages 18 to 49, 73 percent said abortion will be “very important” to their vote, according to a Kaiser Family Foundation (KFF) poll in July. Six in 10 women said they were “more motivated” to vote because of the ruling.

Thirteen states had so-called trigger laws that banned abortion as soon as the ruling took effect, and about a dozen others have attempted to enact bans or restrictions that state courts have blocked for now. After the Supreme Court decision, Georgia banned abortion at six weeks, when there is some detectable fetal electrical activity in cells that will become the heart (often erroneously referred to as a “heartbeat”)—and before many people know they are pregnant. Studies have shown that denying abortion access has wide-ranging negative effects on peoples’ physical and mental health, as well as their economic status.

Five states have abortion measures on the ballot this fall. In Michigan, where the procedure is currently legal by court order, a ballot measure aims to enshrine abortion rights in the state constitution. Republicans narrowly control Michigan’s state legislature, and Democratic Governor Gretchen Whitmer is up for reelection on Nov. 8. In Kentucky, where abortion is now illegal in all cases, a ballot initiative could amend the state constitution to codify the ban. “Abortion tends to do much better when it is on the ballot directly,” says Tracy Weitz, a professor of sociology at American University in Washington, D.C. Kansas voters demonstrated this when they resoundingly rejected a ballot measure restricting abortion rights earlier this year. Vermont and California—where abortion is still legal—have ballot measures that would amend their constitutions to protect abortion rights. Republicans control North Carolina’s General Assembly, but the state has a Democratic governor. If Republicans gain seats in the General Assembly they could override the governor’s veto of an abortion ban.

At the federal level, House Democrats have twice passed a bill to protect abortion rights, but the party lacked the votes in the Senate to pass it and codify it as law. If Democrats can keep the House and grow their Senate majority, President Joe Biden has vowed to send such a bill to Congress. But if Republicans win back one or both houses—as seems likely—they will almost certainly block any such effort, or will even try to outlaw abortion nationally. South Carolina Senator Lindsey Graham has already introduced a federal abortion ban after 15 weeks of pregnancy. But Democrats will continue to block it if they hold either house, or Biden could veto it if it did pass. “It’s unlikely Democrats will win enough votes to be able to eliminate the filibuster and pass an abortion rights bill at the federal level,” Weitz says. “If the Republicans win, they won’t have a supermajority, so they won’t be able to override Biden’s veto.” But Weitz notes that if Republicans win the House, they could launch disruptive investigations into institutions or organizations that are trying to help people travel across state lines to get abortions.

Improving U.S. health care

Many people in the U.S. lacked access to affordable health care before COVID, and the pandemic has exacerbated this problem. Americans collectively lost nearly three years in life expectancy from 2019 to 2021, largely because of the virus that has taken more than a million U.S. lives (far more than in other comparably wealthy countries). Even though effective vaccines and treatments are now available, COVID is still killing more than 350 people in the U.S. each day. As the Northern Hemisphere heads into another pandemic winter, researchers will need more funding to develop protections against new variants—and to improve surveillance for new pandemic threats.

“We absolutely need investment in new treatments and next-generation vaccines. We also need major investments and strategies to actually distribute those to the people who need them,” says Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan. “I don’t see there being strong messaging from the Democratic side about the need for a sustained long-term investment in pandemic preparedness,” she says. “But “if the GOP gets a decisive majority in either house of Congress,” she adds, it’s possible “we’re going to actually see intentional de-investment in all of this. We’re going to see policy go into a place that is decidedly anti-science.”

The Biden administration has asked Congress for more than $22 billion in additional funding for COVID testing, vaccines and treatments. But Republicans have pushed back, citing Biden’s recent remark on CBS’s 60 Minutes that the “pandemic is over.” If the Republicans gain control of Congress they will likely continue to block pandemic funding, and they could pressure the Biden administration not to renew the COVID emergency declaration that covers the cost of COVID treatment and vaccines. This would shift those costs onto insurance companies and individuals. Rasmussen says the GOP is also likely to continue its baseless attacks on Anthony Fauci, the president’s chief medical adviser, over the origins of the virus that causes COVID—instead of funding the basic research and public health infrastructure needed to prepare for future pandemics.

The Inflation Reduction Act (IRA) that Democrats passed this year with no Republican votes contains some of the most ambitious changes to health care since the Affordable Care Act of 2010. Importantly, the new law allows Medicare to negotiate drug pricing and caps Medicare beneficiaries’ out-of-pocket costs at $2,000 a year. It also requires drug companies to pay rebates if the price of Medicare drugs rises faster than inflation, and it extends Affordable Care Act subsidies that Congress passed as part of the American Rescue Plan. “I think there are some wins that have been accomplished with the Inflation Reduction Act recently that I don’t think Biden has explained well enough to people,” says Céline Gounder, senior fellow at the Kaiser Family Foundation and an infectious disease specialist and epidemiologist. “These are measures that actually would have an impact on people’s pocketbooks, particularly for older people, in terms of reducing prescription drug costs if they have Medicare.”

Some Republicans have said that if their party takes over Congress in this election, they could try to challenge parts of the IRA. House Minority Whip Steve Scalise said in August that his party members would soon roll out plans to reverse the bill, though they probably won’t be able to repeal it as long as Biden is in office because he could veto any such effort.

Republicans in several states have also been working to undermine gender-affirming health care for transgender children. In February, Texas Governor Greg Abbott ordered state child welfare officials to investigate such care as child abuse. Alabama and Arkansas have enacted laws banning it for minors, and the Florida Department of Health issued guidance to withhold gender-affirming care from young trans people. The science on transgender care in youth shows such care is safe and affirming, and that withholding it can seriously harm trans children’s mental health—including increasing their risk of depression and suicide. At the national level, House Republicans have proposed a version of what media have called the “Don’t Say Gay” bill, which would prohibit the use of federal funds in teaching children under 10 years old about sexual orientation and gender identity. Many fear such moves will accelerate if Republicans regain control of Congress and state governments.

Reducing greenhouse gas emissions

The climate crisis has not received as much attention this election cycle as it did in the previous one. But it is increasingly damaging lives and livelihoods across the country by intensifying droughts and wildfires, by triggering more rain and flooding from storms, and by fueling record-shattering heat waves.

The latest reports from the United Nations’ Intergovernmental Panel on Climate Change made clear that the window is rapidly closing on humanity’s chance to keep global temperatures from overshooting the target set under the 2015 Paris Agreement. Scientists have determined that the climate accord’s goal—limiting global warming to no more than 1.5 degrees Celsius above preindustrial temperatures—would help avoid many of the ever-worsening effects of climate change. The key to achieving that goal is rapidly curtailing the burning of fossil fuels to generate energy and power vehicles, while building up renewable energy sources. “The science on this is crystal clear,” says Rachel Cleetus, policy director with the Climate and Energy program at the Union of Concerned Scientists.

To help the U.S. meet its Paris Agreement obligations, Biden pledged to reduce the country’s greenhouse gas emissions by 50 percent by 2030 (and re-signed the U.S. onto the agreement after former president Donald Trump withdrew the country from it during his tenure). Economic forces are steadily nudging utilities and consumers in the right direction as renewable energy sources grow more cost-competitive with natural gas, but that alone will not make the clean energy transition happen quickly enough. A crucial tool to hasten the process is the Inflation Reduction Act. It earmarks tens of billions of dollars to incentivize clean-energy manufacturing, electric vehicle adoption and other decarbonization efforts, which are expected to reduce U.S. emissions 30 to 40 percent by 2030.

Much more needs to be done at the federal, state and local levels. Though some Republicans have spoken about the need to address climate change and bolster the domestic clean energy industry, the party has not proffered any significant plans to address climate change. It has resisted moving entirely away from fossil fuels, instead aiming to increase U.S. oil and gas production (as have a few Democrats such as Senator Joe Manchin, who represents the major coal mining state of West Virginia). “The hold of our fossil fuel industry on our politics is clear,” Cleetus says.

Republicans are unlikely to be able to undo the IRA’s provisions without substantial majorities in both houses of Congress. But regaining either chamber could make it easier for them to prevent or delay actions that would further reduce emissions, or to open more U.S. territory to oil and gas drilling. Republican control could also cut agency budgets and staffing for government bodies such as the Environmental Protection Agency, which Republicans have often accused of regulatory overreach in its climate work. Republicans have also indicated they are less likely to support emissions-reducing provisions in the Farm Bill—major spending legislation that is negotiated approximately every five years and will next be up for debate in 2023.

State elections will also partly determine the country’s emissions trajectory. California and New York have ballot proposals that would provide billions of dollars in funding for various climate- and environment-related initiatives, such as building more electric vehicle charging stations. States will also play an important role in implementing the IRA, with state-level lawmakers and public utility commissions in charge of clean energy standards and grid investments, for example. Democrat-controlled states have generally made more commitments to reducing greenhouse gas emissions; in Republican-controlled states, any movement in that direction has been based largely on economic considerations as renewable sources have become cheaper.

Online privacy and free speech

Both Democrats and Republicans have campaigned on curbing the power of Big Tech—an issue that enjoys popular support—but the parties’ motivations and proposals differ. And attempts to pass regulations are likely to move slowly at the federal level no matter who takes control of Congress, though there is some state-level movement that may have national significance.

On the privacy front, lawmakers from both parties have contributed to legislation such as the American Data Privacy and Protection Act. This would prevent companies from collecting users’ data unless they are doing so for a handful of allowed purposes. The ADPPA might have enough momentum to pass no matter which party controls Congress, partly because lawmakers may want to address a patchwork of related state laws that are taking shape. Because such privacy rules apply only to certain regions, it is complex and difficult for companies to enforce them. A federal bill such as the ADPPA could standardize privacy requirements—and depending on the language in the bill, it might override certain state laws in the process.

As Republicans attempt to criminalize abortion in many states and federally, Democratic lawmakers are trying to ensure online privacy protection. They have introduced legislation such as the My Body, My Data Act, which restricts private companies’ ability to collect reproductive health data, and the Health and Location Data Protection Act, which blocks data brokers from selling information about health and location. But this would be unlikely to pass if Republicans gain majorities in the House or Senate. There have also been Republican efforts to restrict what information people can post online about how to obtain an abortion, with Republicans favoring laws that would require sites to remove such content.

The way tech companies control speech has also come under scrutiny from lawmakers in both parties. Democrats’ grievances include the claims that social media platforms enable hate speech and misinformation, while Republicans claim that tech companies have an anticonservative bias that leads to the silencing of right-wing accounts.

To address this issue, federal legislators from both parties have proposed modifying or cancelling Section 230 of the Communications Decency Act—a regulation that allows social media platforms to set their own moderation policies without being legally liable for what people post (the way a news publisher would be). Such proposals have not made much progress, however. The coming election is unlikely to change this situation directly, but various state efforts could do so. As with privacy laws, states have begun passing rules that—if they survive legal challenges—would create a patchwork of different regulations that would be hard for tech companies to enforce. Florida and Texas, for example, have passed Republican-written laws that aim to prevent social media platforms from censoring conservatives. But these laws have been challenged for infringing on the platforms’ First Amendment right to free speech and are currently mired in legal limbo. California’s Democrat-controlled legislature has passed its own law that lets social media companies keep setting their own moderation policies but creates new transparency requirements that force the platforms to disclose exactly what those policies are. Other states have their own moderation-related bills on the way.

Threats to democracy

Underlying whether and how the nation addresses these and other pressing issues—including whether policies are informed by the best possible science and research—is the integrity of elections and whether there is equal access to voting.

After a 2013 Supreme Court decision struck down part of the Voting Rights Act, many states enacted policies including ID laws or the closure of polling places that can amount to voter suppression. Meanwhile, the election conspiracy theories that emerged after the 2020 presidential contest have continued to fester. Right-wing think tanks and other organizations offer training for election deniers on how to become poll workers, says Michael Latner, a political scientist at California Polytechnic State University and a senior fellow with the Center for Science and Democracy at the Union of Concerned Scientists. Latner says they are being instructed in how to challenge ballots, particularly in Democratic-leaning cities and battleground states.

Depending on the outcome of a Supreme Court case on the ability of state courts to interpret state law in election cases, state legislatures may also try to exert more political control over issues such as how a state’s electoral votes are awarded during presidential elections, which could allow state lawmakers to effectively overrule their state’s popular vote.

These efforts disproportionately target communities of color and low-income residents and can leave them disenfranchised, Latner says. And there is considerable research in the U.S. and abroad “demonstrating that the people who don’t have a voice in the process—and cannot hold government accountable—have less influence over the policymaking process, and they bear the burden of poor policymaking,” he says. “It is no coincidence that the people that live in frontline communities and environmental justice communities are also the ones being targeted for voter suppression.”

There is some bipartisan support for reform, Latner says. But so far it has not been enough of a priority, even within the Democratic Party, to pass any basic reforms during the current session of Congress. If Republicans take either or both houses, it is even less likely that those reforms will be passed.

When people are shut out of the democratic process and power is concentrated in the hands of a few, it is harder to craft sound, widely beneficial policies that avoid leaving out or harming some groups of people. “There are very specific similarities between the democratic process and the scientific process in that the fundamental assumptions of how knowledge is built, and how we should move forward as a society, depend on open inquiry, depend on the ability to test claims and to learn from policy outcomes and improve the policymaking process,” Latner says. “And if that process is distorted or broken, then we’re not going to be able to meet the collective challenges that we face as a society.”

Yet again, the stakes going into U.S. Election Day are soberingly high—and the results at all levels of government will have lasting ramifications for millions of human lives on issues ranging from abortion access to the climate emergency. Democrats have held the presidency and both houses of Congress for two years, taking some of the…

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