11 payer mix moves to make now that the midterms are over

Democrats won both chambers of Congress on Nov. 3. The Medicaid work requirements that take effect nationally Jan. 1 didn't budge. CBS News projected Democratic control of the House and Senate late Tuesday, with some races still uncalled Wednesday morning, and Democrats also flipped governor's offices in Ohio, Georgia and Iowa, three states that must run the new rules.

Voters settled two measures practices were watching, too. California's Proposition 44, which would have required community clinics to spend at least 90 percent of revenue on patient care, failed with more than 81 percent of voters opposed, according to The Associated Press. South Dakota voters rejected an amendment that could have ended the state's constitutional duty to cover expansion adults if federal funding dropped below 90 percent. Neither result changes what your staff will see on a January eligibility check.

What did change is the range of plausible outcomes for 2027, and payer mix is where that range lands. Expansion adults face six-month renewals, Marketplace patients are on thinner coverage and Medicare's 2027 rate still needs a final rule. Here are 11 moves to make before your budget locks.