Republicans won’t attach their names to this prediction, but many of them expect Tuesday’s midterms to hand Democrats at least one chamber of Congress. And they’re already bracing for President Donald Trump’s healthcare agenda to get bogged down by a divided government.

The slowdown could happen in a number of ways, GOP aides working on health policy told me — depending on how big an election night Democrats have. At a minimum, Republicans anticipate that a new House majority will haul Trump administration health officials into oversight hearings on a litany of topics, like the still-growing measles outbreak, the president’s slashing of global health aid, and the implementation of Medicaid work requirements.

Those hearings would be designed to trip up administration officials. But even if they don’t yield embarrassing headlines, Republicans are prepared for healthcare policymaking to get hairier. “Preparing for oversight and obstruction from Democrats will take 50% of our time and mean less ability to push for reforms and regulation,” a former GOP congressional staffer said.

Two top Trump health officials have left in the last week alone: Senior health adviser Calley Means and Centers for Disease Control and Prevention Deputy Director Jennifer Shuford. The midterms could complicate the confirmation prospects of several others still awaiting their Senate votes, including Chris Klomp, tapped as No. 2 at HHS, and Heidi Overton, picked to lead the Food and Drug Administration.

The former Republican staffer put it bluntly: “God forbid we lose the Senate — we’re not getting any nominees in.”Even a tiny Senate GOP majority could hand outsized power over health confirmations to a single Republican, like abortion-access supporter Lisa Murkowski of Alaska or libertarian-leaning Rand Paul of Kentucky.

Healthcare bills with bipartisan potential, like measures on hospital price transparency or food labeling, might still find room to break through. But as one former health official told me, it’ll be “mostly gridlock.”