In the current round of coalition negotiations, leaders of the ultra-Orthodox sector are eyeing certain ministries, encouraged by their sector's increased integration into Israeli society over the last few years, their growing electoral strength — Shas and Yahadut HaTorah went from 13 to 16 seats in the April 9 election — and the fact that they are essential to forming a new governing coalition. Both Shas and Yahadut HaTorah are demanding control of the housing and welfare ministries and real power for their deputy ministers, including at the Ministry of Education, with the aim of benefits for their electorate. 

Until 2009, Yahadut HaTorah had made do (for the most part) with the chairmanship of the Finance Committee and a deputy minister with only partial responsibility for the portfolio. This changed with Benjamin Netanyahu’s second government (2009-13), when the party demanded and received control over the Ministry of Health. Yaakov Litzman was given full control over the ministry even though he continued to hold the title of deputy minister. (Ashkenazi ultra-Orthodox have traditionally refused appointment to full ministerial positions because they do not want to be officially responsible for the policies of a secular Jewish state.) Litzman still holds the post and will probably continue to serve as deputy health minister in the next government. He can take credit for several major achievements during his long tenure even though he has been tangled up in criminal proceedings in the last few months.

Litzman has also been involved in frictions involving religious issues. For example, for several months he blocked construction of a secure wing (in the event of rocket fire from Gaza) for Barzilai Hospital, citing concern for ancient graves at the selected site. Nevertheless, he was also responsible for several important measures, including mental health reforms and inclusion of subsidized dental care for children in the health service bundle provided by the government. He continued to promote reforms such as these in the outgoing government, although he occasionally found himself caught in the dilemma of how to best balance his role as a representative of the ultra-Orthodox sector versus his responsibility to provide healthcare for the entire population.

Litzman's dilemma was particularly evident when he fought to stop people from bringing hametz (bread and other leavened products) into hospitals during Passover and when he intervened to ensure that his patron, the rebbe of Ger, and the rabbi’s wife, received preferential treatment while in hospital. On May 21, it was revealed that the rabbi of Hadassah Hospital had been inspired by Litzman when he demanded that emergency room staff prioritize religious patients on Fridays, regardless of medical urgency, so they would not have to violate the Sabbath.