2026 U.S. Health Policy Outlook: Affordability, Medicaid, and Technology Trends

The 2026 health policy landscape is expected to be marked by cautious legislative activity due to intense partisan divisions and the upcoming election year. Key areas to watch include the impact of unaffordable health insurance premiums, especially if enhanced Affordable Care Act (ACA) tax credits are not renewed. Rising premiums could become a significant voter concern, amplified by media and political discourse, influencing public sentiment on health care affordability. Marketplace enrollees may increasingly opt for high-deductible plans due to cost pressures, raising questions about financial security and access to comprehensive coverage, particularly for older and sicker populations. This dynamic could affect the overall uninsured rate and enrollment patterns in 2026. States with Medicaid expansions are preparing to implement Medicaid work requirements in 2027. Variations in state policies could emerge, with some states pursuing stringent enforcement to reduce enrollment and spending, while others may seek flexibility to mitigate impacts in anticipation of possible political shifts. Health care costs are projected to accelerate again in 2026, with employer-sponsored insurance premiums potentially nearing $30,000 annually for family coverage. Increased cost-sharing and deductibles are likely to follow a period of relative stability. Congressional attention may focus on measures such as site-neutral hospital payments and regulations on pharmacy benefit managers (PBMs). Emerging treatments like GLP-1s for weight management present cost management challenges but also opportunities for more measured technology adoption. Drug pricing pressures, initiated during prior administrations and continuing under the current one, are expected to keep retail drug spending under scrutiny, although hospitals remain the largest health care cost drivers. Proposals for hospital price caps and budget controls may gain traction at the state level despite limited federal momentum. Efforts to reduce burdensome prior authorization processes through voluntary industry collaboration are underway, but their effectiveness in easing provider and patient frustration remains uncertain. The Make America Healthy Again (MAHA) movement, reflecting varied public attitudes toward personal responsibility for health, vaccination, and medical care access, continues to influence health discourse. Tracking its impact on public health behaviors like vaccination rates is important for future policy considerations. Artificial intelligence (AI) is increasingly integrated into medical research and care delivery, especially in specialties like radiology. However, its role in addressing consumer concerns about costs and system navigation is still developing, with potential growth in 2026. Additional topics poised for attention include reproductive health policies, ongoing challenges in HIV management, updates from federal health agencies, Medicare Advantage program competition, and enforcement of price transparency rules. Given the complexity and partisan nature of health policy, significant congressional action may be limited, but incremental changes remain critical.