2026 GAHA Annual Meeting and Health Law Update-Federal Update

Federal Update

Pdf Summary

The document is a 2026 healthcare policy update focused on federal legislative and executive developments affecting providers, payers, and health systems.<br /><br />In Congress, the 119th Congress is operating with very narrow margins in both chambers. Major legislative action centered on the “One Big Beautiful Bill Act” (OBBBA), which included Medicaid reforms and cuts, a Rural Health Transformation Program, a temporary Medicare physician fee schedule increase, and limits on some noncitizen access to Medicaid and ACA premium tax credits. The enhanced ACA premium tax credits expired on December 31, 2025, and Congress did not extend them in the 2026 appropriations package, making further extension unlikely.<br /><br />The Consolidated Appropriations Act, 2026 extended several healthcare programs and payment flexibilities, including Medicare telehealth through 2027, Acute Hospital at Home through 2030, various Medicare payment cliffs, Medicaid DSH cuts delays, community health and public health program funding, and PBM transparency reforms. Congressional hearings also emphasized healthcare affordability, transparency, prior authorization, site-neutral payments, and tax-exempt hospital status.<br /><br />Looking ahead, another reconciliation package may advance GOP priorities such as immigration funding and possibly healthcare policy changes like ACA Medicaid expansion reforms, Medicare site neutrality, 340B reform, and Medicare Advantage changes.<br /><br />On the executive side, the Trump administration has aggressively used executive orders, with major impacts on federal grants, DEI programs, gender-affirming care, immigration, drug pricing, and fraud enforcement. Courts have blocked many executive actions, but the administration continues to push policies through CMS, HHS, DOJ, and CMMI. Key themes include Most Favored Nation drug pricing, new 340B rebate efforts, MAHA nutrition initiatives, fraud/waste initiatives, AI-driven prior authorization models, H-1B visa restrictions, and student loan caps affecting several health professions.<br /><br />The presentation closes by noting that 2026 midterms may produce divided government, shaping what healthcare policy changes are feasible next.

Keywords

healthcare policy

federal legislation

Medicaid reforms

Medicare telehealth

ACA premium tax credits

Consolidated Appropriations Act 2026

executive orders

drug pricing

340B reform

prior authorization