A New Year of Working Together to Advance Health in America

Congress returned to Washington this week with a full plate of issues to contend with in the short-term as it defines its legislative agenda for the remainder of 2026. With the mid-term elections only 298 days away, there will be limited time to address their agenda. And as has been the case in recent years, health care issues will be at the center of many of these discussions.  

At the top of Congress’ “must-do” list is funding the federal government for fiscal year 2026. The discretionary congressional budget is the portion of federal spending that Congress sets each year through the appropriations process. It is allocated through 12 annual appropriations bills, each covering a specific area of government, which Congress must pass (or temporarily replace with a continuing resolution) to fund the government for the current fiscal year. Separately, tax and entitlement programs are handled by Congress either through the budget reconciliation process, which allows changes to spending and revenues to pass the Senate with a simple majority, or through standalone legislation considered under regular legislative procedures.

In November, lawmakers approved three appropriations bills for FY 2026 as part of a legislative package to end the government shutdown and fund other departments at existing levels through Jan. 30. Congress still must pass the nine remaining appropriations bills through the end of FY 2026 or enact another continuing resolution to avoid a partial government shutdown.  

The government funding package also is the platform for extending key health care policies that are set to expire Jan. 30. These policies — which include the Low-volume Adjustment and Medicare-Dependent Hospital programs that are critical for rural hospitals, telehealth and hospital-at-home programs, and the moratorium on cuts to the Medicaid Disproportionate Share Hospital program — have been extended in multiple continuing resolutions enacted since last fall. Our message here is clear: Congress must extend these policies to support hospitals in providing patient services and protect access to care for communities.

Meanwhile, Congress continues to discuss the possibility of extending the enhanced premium tax credits, which help low- and middle-income individuals and families purchase insurance on the Health Insurance Marketplace. The EPTCs expired Dec. 31. While the House passed legislation this week for a clean three-year extension, the Senate is not likely to consider this bill. Instead, bipartisan discussions continue in the Senate for a pared back extension. Ensuring that individuals and families have access to affordable coverage and care is essential to the health of our communities. We continue to encourage Congress to reach a bipartisan solution to maintain access to coverage for millions of Americans. 

There's no question that the issue of affordability in general, of which health care is a part, will be part of this year's congressional and administration discussions as well as the mid-term elections. We’re continuing to advocate for solutions to address affordability as we educate the public and policymakers about the underlying costs of caring that contribute to hospital prices. They include significantly rising drug costs and the role of some commercial health insurers’ policies that delay and deny care and add administrative burden and costs to the health care system. At the same time, we also must recognize our responsibility — as well as other stakeholders — to offer more creative and innovative approaches to address this matter through care transformation.

It is not clear what direction and issues Congress will tackle this year, but rest assured, we are preparing for all possibilities, including a potential “Reconciliation 2.0” package that would present another set of challenges and opportunities for advancing key items on our agenda, as well as preventing further cuts in payments for patient care services provided by hospitals and health systems.  

Watch for more details over the next several weeks and months on our advocacy priorities, as well as information about our “We Care, We Vote 2026” project that provides tools and resources to help hospitals get engaged with candidates and educate them on key health care issues.   

We knew that 2026 would be off to a fast start. And it is. We also know that by working together we can ensure that hospitals and health systems remain strong pillars of health and wellness in every community across America.