2026 GAHA Annual Meeting and Health Law Update-Federal Update

Federal Update

Pdf Summary

The presentation reviews major federal healthcare policy developments in the 119th Congress and the Trump administration as of May 2026.<br /><br />Key legislative highlights include passage of the One Big Beautiful Bill Act (OBBBA), which makes major Medicaid changes: new work/community engagement requirements for certain adults starting in 2027, reduced federal Medicaid financing through provider tax and state-directed payment limits, and tighter restrictions on noncitizen access. It also creates a $50 billion Rural Health Transformation Program, gives a temporary 2.5% Medicare Physician Fee Schedule increase for 2026, and limits some noncitizens’ access to ACA premium tax credits. OBBBA also includes major higher-education changes affecting healthcare workforce pipelines, including elimination of Grad PLUS loans for new borrowers and lower borrowing caps for graduate programs, with graduate nursing and several other health professions treated as non-professional degrees.<br /><br />The enhanced Advance Premium Tax Credits expired on December 31, 2025, and despite competing House and Senate proposals, Congress is unlikely to extend them. The 2026 Consolidated Appropriations Act extended several expiring healthcare provisions, including Medicare telehealth flexibilities through 2027, hospital-at-home through 2030, Medicaid DSH delays, community health funding, and PBM transparency reforms.<br /><br />Looking ahead, Congress is focused on healthcare affordability, with hearings on site-neutral payments, transparency, prior authorization, community benefit, and consolidation. Another reconciliation bill or year-end package could advance priorities like ACA/Medicaid reforms, Medicare site neutrality, 340B, and Medicare Advantage changes.<br /><br />The administration remains highly active through executive orders, litigation, drug pricing initiatives, MAHA nutrition efforts, fraud-and-abuse enforcement, CMMI payment models, H-1B visa restrictions, student loan rule changes, DEI curbs, and proposed limits on gender-affirming care. The slides also note that the 2026 midterms are likely to favor divided government.

Keywords

Medicaid

OBBBA

Congress

healthcare policy

ACA premium tax credits

Medicare telehealth

Rural Health Transformation Program

site-neutral payments

drug pricing

executive orders