Democrats’ projected victories in the 2026 midterm elections have given them control of both the House and Senate, setting up a major challenge to Donald Trump’s remaining time in office. Alongside investigations and possible impeachment discussions, another constitutional provision could return to the spotlight: Section 4 of the 25th Amendment, which addresses what happens if a president is unable to perform the duties of the office.

Ratified in 1967, Section 4 allows the vice president and a majority of the principal officers of the executive departments to declare a president unable to serve. Congress can also create another body by law to take the place of those officials. In 2020, Nancy Pelosi and Representative Jamie Raskin proposed a 17-member commission made up of medical professionals and former government officials to assess presidential capacity. The legislation never passed, but Democrats could revisit the idea when the new Congress takes office in January 2027.

Creating a commission would not automatically remove Trump. The vice president would still have to participate in a declaration alongside the required majority of the commission. If that happened, JD Vance would become acting president. Trump could challenge the declaration, and keeping Vance in power against Trump’s objection would require a two-thirds majority in both chambers of Congress. That would be a significant hurdle, even with Democrats controlling the House and Senate.

For now, it remains uncertain whether Democratic leaders will pursue this route or focus on investigations and congressional oversight instead. Questions about Trump’s health have generated public debate, but speculation and observations are not medical diagnoses, nor do they establish that he is unable to serve. The 25th Amendment process has never been used in this way, and whether Democrats attempt to revive the proposed commission could become a major political issue in the months ahead.