Federal Health Policy and the Midterm Elections: Key Insights
At the American Health Law Association’s conference titled “Policy Report from Washington and Midterm Preview,” significant federal health policy issues took center stage. This session, featuring insights from former Congressman Ron Kind and experts Eugenia Pierson and Sonja Nesbit, focused on the legislative and regulatory landscape in Washington, particularly the One Big Beautiful Bill Act (OBBBA) and its implications for the approaching 2026 midterm elections.
Audience engagement drove discussion on key matters, including the potential future of the legislative filibuster, the challenges of legislating in a narrowly divided Congress, and potential Democratic priorities if they regain the House while the current administration remains in office. Notably, regulatory compliance requirements and legislative strategy were highlighted.
The OBBBA was a substantial topic of discussion among the panelists, who highlighted its significant healthcare provisions. These include modifications to Medicaid eligibility, community engagement mandates, restrictions on state Medicaid financing methods, and anticipated impacts on hospitals, health systems, and patient care access.
If Democrats achieve majority control in the House following the midterms, implementing immediate changes to the OBBBA remains challenging due to ongoing divided government dynamics. However, Democrats may focus their oversight efforts on examining Medicaid reductions, hospital financial issues, MFN drug pricing agreements, vaccine policy changes, and Medicare Advantage prior authorization practices.
The conversation also turned towards legislative actions Congress might consider before 2026 concludes. Despite limited time before the elections, topics such as expiring health policy provisions, public health funding renewals, physician reimbursement, 340B drug pricing program reform, price transparency, and Medicare Advantage prior authorization are under active deliberation.
Affordability continues to drive legislative efforts, with healthcare-related committees maintaining an active schedule of hearings. Both political parties aim to demonstrate their commitment to addressing healthcare expenses. Certain topics, like hospital pricing transparency and Medicare Advantage reform, remain areas of potential bipartisan collaboration.
Panelists emphasized that the midterm elections could significantly shift congressional priorities, leadership of committees, and the scope of oversight. Despite this, the presence of slim majorities and reliance on executive actions are expected to persist in shaping federal health policy. For hospitals, healthcare systems, and stakeholders, the session underscored the lesson that legislative gridlock does not halt policy development. Federal healthcare policies continue to evolve through congressional hearings, legislative drafts, and agency regulations, prompting panelists to advocate for sustained stakeholder involvement to ensure their perspectives are represented in ongoing policy discussions.