With the results now in from the historic and tumultuous 2024 election, the federal government’s power players will once again be shaken up, but the result will be familiar — a tenuous governing environment requiring a party in lock-step. Newly elected President Trump and the officials he appoints will have to work with slim majorities in the House and Senate for any major health policy transformation. Where limited to executive action alone, they will likely reduce implementation support for past Biden and Obama administration flagship priorities, such as the Affordable Care Act and the Inflation Reduction Act.