About 112 new members are likely to join the 120th Congress in January. Very few of them have said anything in public about foreign assistance or global health. That gives advocates a rare opening: the chance to help shape a new member's first positions, rather than to look for champions who are already in place.
Kyle House Group reviewed the candidates in every open and competitive race ahead of the Nov. 3 election. We looked for backgrounds in health, international development, diplomacy and national security, and for anything the candidates have said on PEPFAR, USAID or global health security.
Bottom line
The class is large. We expect about 112 new members: 76 from open House seats, 13 from open Senate seats and 23 from House seats where the incumbent is likely to lose. Another 41 competitive House races could add more.
There are no champions yet. None of the 15 highest-priority candidates has a public statement on PEPFAR, USAID or global health security that we could find. Few have said anything about U.S. engagement abroad beyond the Iran war, Israel and alliances.
The strongest records fall into three groups. Health professionals: Amish Shah (AZ-01), a physician with a public health degree, and Ralph Alvarado (KY-06), a former Tennessee health commissioner. Development and diplomacy: Tom Perriello (VA-05), former U.S. Special Envoy for Sudan; Kelly Kirschner (FL-16), a former Peace Corps volunteer; and Chris Backemeyer (NE-01), a former State Department official. National security: Cait Conley (NY-17), Eileen Laubacher (CO-04), Nancy Lacore (SC-01) and Elaine Luria (VA-02).
Several likely winners in safe seats bring relevant experience. They include Luke Bronin (CT-01), a Navy Reserve intelligence officer who deployed to Afghanistan, and Dan Koh (MA-06), a Biden administration alumnus.
Where the new members will come from
The Cook Political Report's Oct. 23 ratings put 81 House seats in the Likely, Lean or Toss-Up columns. Twenty of those are open, so each is guaranteed to produce a new member. In the other 61, a challenger becomes a freshman only if the incumbent loses.
Open House seats: 76 in total. Twenty are competitive and 56 are rated safe for one party. Eleven are open because the incumbent lost a primary.
House seats likely to change hands: 23, where Cook's ratings or new district maps put the incumbent at real risk.
Open Senate seats: 13, five of them competitive. Ten were held by Republicans and three by Democrats.
Some departures matter directly for foreign assistance. Rep. Michael McCaul (TX-10), former chair of the House Foreign Affairs Committee, is not running again. Rep. Steny Hoyer (MD-05), a longtime appropriator, is retiring. In the Senate, Sen. Dick Durbin's retirement takes a senior appropriator off the Appropriations Committee, and Sen. Jeanne Shaheen, ranking member of the Senate Foreign Relations Committee, is also leaving.
Fifteen candidates to watch
We ranked candidates first by how closely their background connects to health, development or security, and second by their odds under Cook's ratings.
Tier 1: a direct health or development record
Amish Shah (AZ-01, D, open seat; Lean D). Physician with a public health degree and former state representative. The best fit on global health.
Ralph Alvarado (KY-06, R, open seat; Toss-Up). Physician, Tennessee Commissioner of Health from 2023 to 2025 and Kentucky state senator from 2015 to 2023. A rare Republican public health official and a natural bipartisan voice on health security.
Stefany Shaheen (NH-01, D, open seat; Likely D). Daughter of Sen. Jeanne Shaheen, ranking member of the Senate Foreign Relations Committee. She has no foreign policy record of her own, and her campaign centers on medical research.
Tom Perriello (VA-05, D, challenger; Likely R). Former Special Envoy for Sudan, former Special Envoy for the Great Lakes region and the Democratic Republic of the Congo, and former congressman. The deepest development record of any candidate, in a seat that leans Republican.
Kelly Kirschner (FL-16, open seat; Likely R). Spent four years in the Peace Corps in Guatemala and is a former mayor of Sarasota. Real development field experience, in a Republican-leaning seat.
Nancy Lacore (SC-01, D, open seat; Lean R). Former Chief of Navy Reserve who commanded Camp Lemonnier in Djibouti. A security and global posture background rather than health.
Tier 2: a foreign policy, security or health sector background
Cait Conley (NY-17, D, challenger; Toss-Up). West Point graduate, Army officer in Iraq and Afghanistan, and former counterterrorism director on the National Security Council.
Janelle Stelson (PA-10, D, challenger; Lean D). Studied international politics in Vienna, wrote speeches at the Egyptian embassy and reported from Kosovo with the Pennsylvania National Guard.
Rebecca Bennett (NJ-07, D, challenger; Lean D). Health care executive and former Navy aviator.
Elaine Luria (VA-02, D, challenger; Lean D). Former congresswoman and vice chair of the House Armed Services Committee, and a 20-year Navy officer.
Eileen Laubacher (CO-04, D, challenger; Lean R). Retired Navy rear admiral and former senior policy adviser on the National Security Council.
Jonathan Nez (AZ-02, D, challenger; Lean R). Former president of the Navajo Nation.
Chris Backemeyer (NE-01, D, challenger; Likely R). Former Deputy Assistant Secretary of State for Iranian Affairs and a sanctions negotiator in the Iran nuclear talks.
Mike Bouchard Jr. (MI-10, R, open seat; Toss-Up). Army captain, Iraq veteran and Bronze Star recipient.
David Flippo (NV-02, R, open seat; Lean R). Former Air Force lieutenant colonel with Middle East deployments and a small business owner.
What they have said so far
None of these 15 candidates has a public statement on foreign aid, PEPFAR or global health security in the sources we reviewed. Their closest statements are on domestic health care and on the conflicts dominating the news:
Health care costs and coverage. Shah and Shaheen oppose the Medicaid cuts in the 2025 reconciliation law. Alvarado supports the law and runs as a "MAHA doctor" on affordability. Bouchard backs hospital price transparency and most-favored-nation drug pricing.
The Iran war. Conley has criticized the administration's handling of the war, and Bouchard wants it to end.
Alliances and security. Bennett has pledged to strengthen partnerships with allies. Conley worries that the focus on cartels is crowding out preparedness against China and Russia. A group endorsing Laubacher says she would work on "biological risks."
For most of these candidates, their careers say more than their campaigns. Perriello's work as envoy focused on civil conflict, famine and displacement. Kirschner presents his Peace Corps service as background rather than policy.
What this means
A freshman's first positions on foreign assistance are usually formed in the months between the election and their first votes. With a class this large, and so few existing positions on the record, that window matters more than usual. Members with medical, development and security backgrounds are the most natural partners. Each will still need a clear, district-level case for why global health investments matter at home.
Sources: The Cook Political Report House ratings (Oct. 23, 2026) and Senate ratings (Oct. 20, 2026); The Green Papers; state election results; candidate websites and news coverage. Nominee information is current as of Oct. 30, 2026.
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