Healthcare 2026: Politics, Policy & The Future

The early months of 2026 are revealing a period of significant, if incremental, progress in US healthcare policy, a landscape shaped by the approaching midterm elections and persistent concerns about affordability. Even as broad, sweeping changes remain elusive in a deeply divided Congress, lawmakers are making headway on issues like telehealth access, rural health funding, and streamlining prior authorization processes – areas where bipartisan consensus is proving possible. This shift from short-term fixes to more durable policy adjustments signals a potential turning point for the sector, though substantial challenges remain.

Telehealth’s Evolving Status

One of the most notable developments has been the extension of Medicare telehealth coverage policies. Initially expanded during the COVID-19 pandemic as a necessity, telehealth has become a standard of care for many patients and healthcare systems. However, the future of these expanded policies has been uncertain, with previous extensions often being temporary. Congress recently approved an extension through 2027, allowing physicians to provide telehealth services regardless of a patient’s geographic location. This removes previous restrictions that required patients to travel to designated healthcare facilities for virtual visits. As Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association (MGMA), explained, this represents a departure from the “limping along” approach of the previous year, where Congress primarily passed short-term extensions. MGMA outlines these developments in detail.

Prior to the pandemic, Medicare coverage for telehealth was limited primarily to rural areas, and even then, required a visit to an “originating site.” The expansion has dramatically increased access to care, particularly for patients in underserved communities and those with mobility issues. The 2027 extension provides a degree of stability, allowing practices and health systems to continue investing in and offering these services. However, the lack of a permanent solution continues to create uncertainty for long-term planning.

Addressing Prior Authorization Burdens

Beyond telehealth, Congress is as well beginning to address the administrative burden of prior authorization, a frequent source of frustration for both physicians, and patients. Prior authorization requires healthcare providers to obtain approval from insurance companies before certain procedures or medications can be covered. This process can be time-consuming, delaying care and adding to administrative costs. Efforts to reform these requirements, particularly within Medicare Advantage plans, are gaining momentum. The MGMA is actively advocating for solutions to streamline this process and reduce unnecessary delays.

Medicare Advantage and the Path Forward

Medicare Advantage, a private health insurance option for Medicare beneficiaries, has seen significant growth in recent years. However, it has also been criticized for its often-complex prior authorization requirements. Reforms aimed at reducing this burden could significantly improve the patient experience and reduce administrative costs for providers. The specifics of these reforms are still being debated, but the focus is on establishing clearer guidelines and reducing the number of services requiring prior authorization. Health Affairs’ coverage of health policy crossroads highlights the broader context of these debates.

The Broader Political Landscape

These policy developments are unfolding against the backdrop of a highly charged political environment. The upcoming midterm elections are already influencing Congress’s priorities, with affordability remaining a top voter concern. Mounting cost and access pressures are intensifying demands for action on healthcare. However, with thin margins and a deeply divided Congress, the prospects for major legislative breakthroughs are limited. ML Strategies’ 2026 US Health Care Policy Outlook emphasizes the challenges posed by this political climate.

The focus is likely to be on incremental changes and areas where bipartisan agreement is possible. This includes extending existing programs, making modest adjustments to existing policies, and addressing administrative burdens. More ambitious proposals, such as comprehensive healthcare reform, are unlikely to gain traction in the current political environment.

Rural Health Payments and Access

Alongside telehealth and prior authorization, Congress is also addressing rural payment policies. Maintaining access to healthcare in rural areas remains a significant challenge, with many rural hospitals and clinics facing financial difficulties. Efforts to adjust payment rates and provide additional funding for rural healthcare providers are aimed at ensuring that residents of rural communities have access to essential healthcare services. These adjustments are often tied to maintaining critical access hospital status and supporting telehealth infrastructure in underserved areas.

The extension of telehealth policies is particularly important for rural communities, as it allows them to access specialists and other healthcare services that may not be available locally. However, ensuring that rural providers have the necessary infrastructure and broadband access to support telehealth remains a challenge.

What Comes Next: A Procedural Outlook

The coming months will likely see continued debate and negotiation on these and other healthcare policy issues. Congress will need to address a number of expiring provisions and funding streams, creating opportunities for further policy adjustments. The outcome of the midterm elections will also play a significant role in shaping the healthcare agenda. Regardless of the election results, This proves likely that healthcare will remain a central issue in Washington, with affordability and access continuing to be major concerns. Expect ongoing scrutiny of Medicare Advantage plans and continued efforts to address administrative burdens. Further legislative action will likely be incremental, focusing on targeted reforms rather than sweeping changes. The MGMA and other healthcare advocacy groups will continue to play a key role in shaping the policy debate and advocating for the interests of their members.