2026 U.S. Legislative and Regulatory Outlook: Implications for Insurance and Infrastructure

As the United States prepares for the 2026 legislative year, several key policy areas will undergo significant developments impacting insurance, healthcare, infrastructure, and regulatory compliance across industries. Congress is expected to focus on legislation such as Budget Reconciliation 2.0, Surface Transportation Reauthorization, and annual appropriations, amidst evolving priorities shaped by both legislative and executive actions. In healthcare, there is considerable uncertainty regarding the future of Affordable Care Act (ACA) enhanced premium subsidies set to expire, with potential impacts on millions losing coverage or facing higher out-of-pocket costs. Medicaid work requirements and income-verification measures are expected to influence coverage dynamics. Healthcare affordability and access remain top issues, particularly affecting rural and safety-net hospitals, signaling probable shifts toward consumer-empowerment strategies including health savings accounts (HSAs) or flexible spending accounts (FSAs). FDA user fee programs essential for prescription drug, biologics, medical devices, and biosimilar reviews face reauthorization in 2026 to maintain regulatory efficacy. The reauthorization process will include negotiations for user fees and performance goals, impacting the agency’s budget and regulatory functions. The FDA’s ongoing reforms, including new processes for sunscreen ingredient approvals and initiatives to phase out petroleum-based synthetic dyes, reflect a broader regulatory modernization effort. The public health sector faces increasing complexity with decentralized vaccine policies driven by leadership changes and regional alliances such as the West Coast Health Alliance, affecting payers and providers navigating variable immunization schedules and reimbursement standards. Inflation Reduction Act provisions influencing negotiated drug prices and rebate models will shape drug formularies and access for low-income and safety-net populations, with significant policy experimentation anticipated in 2026. Agriculture policy remains in flux with the delayed Farm Bill 2.0 discussions, bipartisan support for precision agriculture, and updates to labor visa programs. USDA budget and workforce challenges heightened by government shutdowns necessitate close legislative attention for program funding continuity. Infrastructure legislation is poised for action, with House passage of permitting bills and a Senate-led reauthorization bill anticipated. Renewed federal emphasis on nuclear energy includes tax credits, streamlined licensing, and regulatory modernization under the Nuclear Regulatory Commission (NRC). Comprehensive reforms are expected in endangered species regulations and permitting processes under acts aiming to expedite infrastructure projects. Environmental regulatory focus includes PFAS management, the Lautenberg Chemical Safety Act reauthorization, and water infrastructure financing, with EPA programs requiring congressional reauthorization. Disaster management is set for transformation via the Fixing Emergency Management for Americans Act and parallel FEMA reforms, emphasizing state roles in disaster preparedness, recovery, and insurance cost management. Trade and tariff policies remain dynamic, with ongoing challenges from tariffs imposed during the Trump Administration and pending Supreme Court decisions on presidential tariff authority. Local governments face fiscal impacts from tariffs compounded by changes in federal funding. Emerging regulatory challenges include the rise of online prediction markets rebranded to bypass gambling laws, prompting calls for Congressional amendments to the Commodity Exchange Act. AI regulation gains urgency amid a patchwork of state laws, with potential federal preemption efforts. Cybersecurity advances include the implementation of mandatory incident reporting for critical infrastructure under CIRCIA, requiring rapid reporting of cyber incidents and ransomware payments. Technology and supply chain security policies gain prominence with increased controls on advanced technologies, export controls on AI chips, and expanded scrutiny on foreign investments in critical sectors. Space and quantum initiatives progress with NASA reauthorization, FAA regulatory updates for commercial space operations, and anticipated executive orders on quantum technology reflecting national security and industrial base priorities. Education reforms continue under the One Big Beautiful Bill Act with a focus on student loan updates, accreditation, and institutional accountability, alongside ongoing pressures for higher education cost transparency and regulatory scrutiny. Congressional oversight intensifies with bipartisan investigations across sectors, emphasizing trade enforcement, sanctions on Iran, Latin American entities, and Russian energy firms, reflecting complex geopolitical considerations. Transportation policy advances include delayed but continued efforts on Surface Transportation Reauthorization, FAA air traffic control modernization funded by the Infrastructure bill, and initiatives supporting autonomous vehicles and unmanned aircraft systems, with regulatory and legislative frameworks evolving. Maritime policy receives renewed federal attention with nominations to the Federal Maritime Commission and legislation aimed at revitalizing the U.S. maritime industrial base, strengthening enforcement, and adjusting port service fee policies. U.S. foreign investment regimes continue to tighten with expanded CFIUS oversight and outbound investment scrutiny, focusing on technology supply chain security and national defense priorities. This comprehensive 2026 policy outlook underscores the interconnectedness of legislative, regulatory, and market forces impacting U.S. insurance professionals, healthcare payers, infrastructure stakeholders, and regulatory compliance experts, necessitating proactive monitoring and strategic adaptation to evolving federal initiatives.