The healthcare industry will see significant changes in 2026 as several of President Donald Trump’s policies take effect in the new year.
The president and Health and Human Services Secretary Robert F. Kennedy Jr. have shaken up the status quo in several areas of health policy in 2025 with their “Make America Healthy Again” agenda. However, some of the biggest changes are set to take effect starting in 2026, including prescription drug pricing, federal hospital funding, and Medicaid eligibility.
The GOP’s budget reconciliation bill, the One Big Beautiful Bill Act, passed in July, and it includes sweeping changes to the healthcare system, including to Medicaid and Obamacare, that will be implemented over the next several years, with certain policies starting in 2026.
Prices for some prescription drugs will also change in 2026, with both the Trump administration’s negotiations with pharmaceutical companies and former President Joe Biden’s Medicare Drug Price Negotiation Program taking effect.
Here is a rundown of all the measures to watch out for in 2026.
Rural Health Transformation Fund
In January, all 50 states are set to receive a portion of $10 billion in federal rural health funding, with the goal of revitalizing struggling healthcare systems nationwide.
Congressional Republicans included $50 billion in rural health revitalization funding to be dispersed over five years as part of the One Big Beautiful Bill Act, added to the broader bill in part to offset cuts to hospital funding in the Medicaid reform portions of the legislation.
The statute requires that each state receive $100 million annually and then an additional sum on a competitive basis based upon proposals submitted to the agency before Nov. 1. The Centers for Medicare and Medicaid Services on Dec. 29 announced the amounts that each state will receive fall between $145 million and $281 million.
CMS Administrator Dr. Mehmet Oz said during the announcement of the first year’s funding that many parts of the country “have fallen tragically behind” in their healthcare systems that are “no longer functioning at the pace and at the efficiency that one would have expected.”
“This is a massive effort to change the unfortunate reality that has occurred to rural healthcare in America, which is that your zip code has started to predict your life expectancy,” Oz said.
Earlier this year, Oz told the Washington Examiner that the goal of the funding is to improve quality and access to healthcare, such as through medical licensing reciprocity and expanding telehealth capacity.
TrumpRx and ‘Most Favored Nation’ drug pricing
Trump has made lowering prescription drug prices a key component of his healthcare agenda by pushing the “Most Favored Nation” program, calling for drugmakers to price medications sold in the United States at the lowest cost available in peer countries.
The policy started with five companies announcing deals with the White House this fall, including Pfizer, AstraZeneca, Eli Lilly, Novo Nordisk, and EMD Serono.
On Dec. 19, nine new drugmakers agreed to lower prices voluntarily for products taken by hundreds of millions of Americans to treat cancer, diabetes, autoimmune conditions, and cardiovascular diseases. Those companies include Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead, GSK, Merck, Novartis, and Sanofi.
Patients are expected to be able to access these new lower-priced medications through the platform TrumpRx.gov, a direct-to-consumer website that links patients to deals on the pharmaceutical company’s website. Administration officials say the TrumpRx platform will be live in January.
The president also said this month that he will likely begin calling executives of insurance companies in January to see if he can negotiate similar agreements for them to lower insurance premiums voluntarily.
Trump touted his success with “Most Favored Nation” negotiations during his end-of-the-year video address on Dec. 17.
“I’m doing what no politician of either party has ever done — standing up to the special interests to dramatically reduce the price of prescription drugs,” he said.
Medicare drug price negotiations taking effect
While Trump’s “Most Favored Nation” deals have received more attention this year, new prices negotiated by the Biden administration for the 10 most expensive drugs within the Medicare program will take effect on Jan. 1.
Under Biden’s Inflation Reduction Act, CMS negotiated lower prices for 10 drugs in 2024 that were the most expensive for Medicare Part D, which covers self-administered prescription medications for seniors.
Those new prices, taking effect in 2026, are estimated to save Medicare an estimated $1.5 billion. Medications include the diabetes drug Januvia, the rheumatoid arthritis medication Enbrel, and the blood thinner Eliquis, among others.
Several lawsuits from pharmaceutical companies against the administration failed this year as various courts upheld CMS’s right to negotiate drug prices for Medicare under the Inflation Reduction Act.
Medicaid changes made by GOP
How Medicaid covers immigrants will change in the new year as parts of the GOP budget bill passed this summer take effect in the fall of 2026.
Many of the more complicated changes to the program, including federal work requirements for able-bodied individuals without dependents on Medicaid, will be implemented over the next several years, but some of the rules regarding immigrants will take effect in October 2026.
HOUSE GOP OBAMACARE PROPOSAL: WHAT TO KNOW ABOUT THE PLAN
Beginning Oct. 1, the definition of “eligible alien” for Medicaid coverage will change to restrict eligibility to lawful permanent residents, certain Cuban and Haitian immigrants, and a handful of other categories. This will end eligibility for a variety of other categories of immigrants, including asylees, refugees, and survivors of trafficking.
The GOP budget bill also cuts federal matching funds for Medicaid coverage during medical emergencies, including childbirth, for those who would qualify for Medicaid except for their immigration status. Those funding cuts also take effect Oct. 1.
