Virginia voters deliver a “blue tsunami” — what it means for emergency medicine
Compiled from information provided by Commonwealth Strategy Group
Governor-elect Abigail Spanberger at her victory party (Photo credit: Spanberger campaign)
When polls closed across Virginia on November 4, all eyes were on the Commonwealth — and the results were decisive. What many expected to be a competitive election turned into a “blue tsunami,” as Democrats swept every statewide office and more surprisingly expanded their majority in the House of Delegates.
A historic night
Abigail Spanberger made history as the first woman elected Governor of Virginia, defeating Republican Winsome Earle-Sears by more than 15 points. Spanberger, a former congresswoman known for her moderate tone and focus on bipartisanship, drew strong support from women, minority voters, and Northern Virginia’s federal workforce, many of whom were impacted by this year’s federal layoffs.
Ghazala Hashmi, a state senator from Richmond, was elected Lieutenant Governor, becoming the first Muslim woman elected to statewide office in U.S. history. In the Attorney General race, Jay Jones defeated incumbent Jason Miyares despite a campaign overshadowed by controversy — further evidence of the Democratic surge.
Democrats expand power
In the House of Delegates, Democrats gained 13 seats, increasing their majority from 51 to 64 seats — the largest in over a decade. With full control of the Executive Branch, Senate, and House, the party now holds a strong hand heading into the 2026 General Assembly session.
Among the new faces are several legislators representing regions with major hospital systems and growing healthcare needs — including Delegate Lily Franklin (D–Montgomery/Roanoke), who unseated Chris Obenshain; Delegate May Nivar (D–Henrico/Goochland), who flipped a central Virginia seat once held by a Republican freshman; and Delegate Kimberly Pope Adams (D–Petersburg), who reclaimed her seat in a high-profile rematch.
what it means for emergency medicine
Williamsburg pediatrician Mark Downey, M.D. is the first physician in the General Assembly since Sen. Siobhan Dunnavant was defeated in November 2023.
For emergency physicians and health advocates, the election results set the stage for a policy environment that may look quite different next year. With Democrats controlling both chambers, expect renewed debate around key issues affecting emergency care — from Medicaid reimbursement and mental health funding to workforce protections and patient access. Budget pressures and reimbursement will pose challenges to the entire house of medicine, as disruptive changes to federal spending on Medicare and Medicaid could create a dire turning point for Virginia's healthcare economy.
While too early to predict the full legislative agenda, early signals suggest the new administration will prioritize public health, reproductive rights, and social safety net investments — areas that could indirectly impact emergency departments across the Commonwealth. There’s also a physician back into the legislature for the first time in a year: Democrat Mark Downey, M.D., a Williamsburg pediatrician, beat freshman Republican Chad Green. That was one of 13 races that added to a 64-36 Democratic majority in the House of Delegates.
Indeed, the sheer number of new legislators — 17 in total — means a steep learning curve for many on the nuances of emergency medicine and health system challenges. That’s where VACEP’s advocacy becomes critical: ensuring emergency physicians remain a strong, informed voice in Richmond.
VACEP at the Capitol
As the 2026 General Assembly session approaches, VACEP will continue to engage lawmakers from both parties, educate new members about the realities of emergency care, and advocate for policies that support physicians and protect patients.
We’ll share a full legislative preview and details on January 28th’s EM Advocacy Day in the coming weeks. In the meantime, members are encouraged to stay engaged, follow updates from the VACEP legislative team, and connect with newly elected representatives in their districts.
House seats that flipped from R to D
House District 22 (Prince William) - Former House of Delegates member Elizabeth Guzman (D) defeated incumbent Ian Lovejoy (R) by over 9%
House District 30 (Loudoun/Fauquier) - John McAuliff (D) was able to defeat incumbent Geary Higgins (R) by 1.5%
House District 41 (Blacksburg/Roanoke County) - Lily Franklin (D) ran again against Chris Obenshain (R) and was able to win by 2.5%
House District 57 (Western Henrico) - May Nivar (D) defeated incumbent David Owen (R) by over 10%
House District 64 (Stafford) - Stacey Annie Carroll (D) defeated incumbent Paul Milde (R) by over 5%
House District 66 (Spotsylvania/Caroline County) - Nicole Cole (D) defeated incumbent Bobby Orrock (R) by over 4%
House District 69 (Peninsula Virginia) - Mark Downey (D) defeated incumbent Chad Green by almost 3%
House District 71 (James City/Williamsburg) - Jessica Anderson (D) ran again against incumbent Amanda Batten (R) and was able to defeat her by over 5% to flip
House District 73 (Western Chesterfield) - Leslie Mehta (D) defeated incumbent Mark Earley, Jr. (R) by 3%
House District 75 (Chesterfield/Hopewell) - Lindsey Dougherty (D) defeated incumbent Carrie Coyner by 5%
House District 82 (Petersburg/Dinwiddie) - Kimberly Pope Adams (D) ran again against Kim Taylor (R) and was able to win considerably by 7%
House District 86 (Hampton/York/Poquoson) - Virgil Gene Thornton, Sr. (D) defeated incumbent A.C. Cordoza (R) by 7%
House District 89 (Chesapeake/Suffolk) - KaceyCarnegie (D) faced Mike Lamonea (R) in a previously held Republican seat after the Baxter Ennis (R) retired, Carnegie was able to win easily by 9%
Where Rs kept seats
Four Republican House Members did not seek reelection this term. One of those seats, House District 89, flipped in the election. However, three new Republicans were able to hold their Republican districts and will join the 13 freshman Democratic House Members in the General Assembly.
House District 46 (Wythe/Smyth/Grayson) - Mitchell Cornett (R) defeated Democratic challenger Jamie Ralston Hendry for the seat previously held by Jed Arnold (R)
House District 49 (Danville/Pittsylvania/Halifax) - Madison John Redd Whittle (R) narrowly defeated Gary Miller (D) for the seat previously held by Danny Marshall (R)
House District 62 (Piedmont) - Karen Hamilton (R) secured her seat in a face off against Sara Ratcliffe (D) for the seat previously held by Nick Freitas (R)
