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Congress is expected to return after the November 2026 midterms with limited time to complete year-end legislation. Policy watchers see a Medicare physician payment adjustment and routine program extensions as more likely than major changes to surprise billing or the 340B drug program; the outcome depends on negotiations and what gets attached to must-pass bills.
Congress could take up a Medicare physician payment adjustment and routine health program extensions after the November 2026 midterms, while proposals to revise surprise-billing rules or the 340B drug discount program appear less likely to advance quickly, according to health policy experts interviewed by MedPage Today. Any measures would probably be attached to must-pass legislation, and the eventual agenda will depend partly on the election’s projected effect on party control and committee leadership.
Lawmakers will have limited legislative days after the election to finish the year’s work. Michael Baker, director of health policy at the American Action Forum, told MedPage Today that the return of sitting members, anticipated committee chairs and ranking members, and projected party control could affect which measures move before the new Congress takes office. He said appropriations bills, the National Defense Authorization Act and the Farm Bill could serve as vehicles for health provisions.
A Medicare “doc fix” is among the more plausible possibilities. Joe Antos, a senior fellow emeritus at the American Enterprise Institute, said Congress could face pressure to address a proposed reduction of more than 1% in Medicare physician payments and a Centers for Medicare & Medicaid Services plan to limit payment for same-day physician services. Antos said a change might be included in a final budget bill, but no agreement or legislative action has been announced.
Routine extensions of health programs may also feature in a year-end package. Wendell Primus, a visiting fellow at the Brookings Schaeffer Initiative on Health Policy, said an extenders package could include community health centers, which he put at a cost of $4.4 billion. Baker said Medicare telehealth authority and acute hospital care at home had already been authorized beyond this year, leaving more standard extensions for lawmakers to consider.
Likely Year-End Health Measures
The post-election session may determine whether providers and health programs receive near-term policy or funding adjustments before the next Congress begins. A Medicare payment change could affect physician reimbursement, while community health center extensions could preserve support for those facilities. These are possibilities described by policy observers, not enacted decisions.
The prospects matter because broader health policy changes may have to compete for space on legislation Congress considers necessary to pass. Attaching a health measure to a must-move bill can create an opportunity to advance it, but it also means negotiations over unrelated provisions may shape whether the health measure survives.
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How Year-End Legislation Could Carry Health Policy
The election will not immediately seat new members of Congress. However, Baker told MedPage Today that expectations about next year’s party balance and committee leadership could influence decisions by current members about whether to advance a proposal now or leave it for the next Congress. A potential future committee role may affect members’ priorities during the remaining 2026 legislative days.
Several issues in the discussion concern existing policies. The No Surprises Act protects patients from certain unexpected out-of-network bills when they receive care at an in-network facility. Its arbitration process has drawn complaints from insurers and providers, even as Antos said the law had achieved its main goal. The 340B program gives eligible hospitals access to discounted outpatient drugs; the Trump administration has proposed replacing the current upfront-discount structure with rebates. No final congressional agreement on either issue was reported.
“Post-election health policy productivity will depend not only on projected party control of the chambers, but also which sitting members are returning next year, and who may be expected to assume gavels in the new Congress.”
— Michael Baker, director of health policy at the American Action Forum
Which Proposals Can Win Agreement
No final legislative package or confirmed health provisions were identified in the report. It remains unclear which must-pass bills will move, whether congressional leaders will attach health measures to them, and how election results and anticipated committee assignments will affect negotiations.
The scope of any Medicare payment adjustment is also unsettled. For surprise billing and 340B, experts cited disagreement or a lack of consensus on preferred solutions. Baker said those proposals could be debated but might not advance rapidly even if included in a must-pass bill. A potential price-transparency measure was raised as another possibility, not a confirmed item on the agenda.
Congress Returns After Election
After the November midterms, lawmakers are expected to return to complete the remaining legislative business of 2026. The next indicators will be which appropriations, defense and Farm Bill measures advance, and whether negotiators include health policy provisions in those bills or a year-end budget package.
Until Congress releases bill text or leaders announce an agreement, the potential measures remain forecasts from policy observers. The report’s sources expect the session to focus, at most, on extensions and targeted adjustments rather than fundamental changes.
Key Questions
What health measure may be most likely to pass after the midterms?
Policy observers identified a Medicare physician payment adjustment, often called a “doc fix,” as a possibility. No measure has been agreed to or passed.
Could Congress change the No Surprises Act this year?
Experts said a fix is possible to debate but difficult to advance quickly because there is not clear agreement on a solution. One expert predicted Congress would leave the issue for next year.
What could happen to the 340B drug discount program?
The Trump administration has proposed shifting 340B from upfront hospital discounts to rebates. A policy observer predicted that action could be delayed, but Congress has not confirmed a decision.
Why would health provisions be added to other bills?
Congress may have limited time after the election, and health measures could be attached to must-pass legislation such as appropriations bills, the National Defense Authorization Act or the Farm Bill.
Source: medpagetoday.com
