Since the beginning of 2026, federal lawmakers have been pitching reforms that touch every corner of the payer space, from government-run programs to how insurance companies conduct business.
Here are eight bills from 2026 that payers should keep on their radar:
1. Sen. Andy Kim, D-N.J., introduced his “MediKids” bill July 21, which would make Medicaid coverage available to those up to 26 years old and extend the age range for the program’s Early and Periodic Screening, Diagnostic and Treatment benefit to align.
2. Rep. Angie Craig, D-Minn., proposed the Medicare-X Choice Act July 15. The legislation would form a government-run public health insurance option on the ACA exchanges and permanently extend enhanced premium subsidies that lapsed leading up to 2026.
3. House Democrats rolled out the Saving Medicare Enrollees from Deceptive Insurers and Creating Ample Resources for Everyone Act. The legislation would end Medicare Advantage’s quality bonus program, as well as exclude or modify diagnosis codes to prevent upcoding.
4. In late June, Democratic senators pitched the Medicare Cost Cap Act, which would cap out-of-pocket costs for traditional Medicare beneficiaries. The bill did not outline a funding mechanism but came as Medicare’s Hospital Insurance Trust Fund, which finances Part A, anticipates a funding cliff by 2033.
5. In April, Rep. Eric Burlison, R-Mo., introduced the Great American Healthcare Plan. The package includes health savings account expansion, “health marketplace pools” and transparency requirements for hospitals, labs, ASCs and insurers.
6. That same month, Rep. Greg Murphy, MD, R-N.C., introduced the Every Dollar Counts Act, which would enable out-of-pocket expenditures for some drugs to count toward a deductible and out-of-pocket maximum.
7. The Break Up Big Medicine Act, introduced by Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., in February, would prevent companies from owning an insurer or pharmacy benefit manager, coupled with a provider or management services organization. It would also stop parent companies of prescription drug or medical device wholesalers from owning provider or management services organizations. Mark Cuban supported the bill.
8. Much like the Medicare-X Choice Act, the Affordable Consumer Health Options and Insurance Competition Enhancement Act from January would allow HHS to offer a public option on exchanges at bronze, silver and gold levels.
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