Congress unlikely to take up major health care legislation this year

The November midterm elections will be Congress’ priority for the remainder of 2026, and observers believe that any legislation coming out of the Capitol will be seen through that electoral prism.

At the AHIP Medicare, Medicaid, Duals and Commercial Markets Forum in Washington, a panel of Congressional watchers gave their views on what the legislative branch of government will prioritize in the coming year.

History tells us that the Democrats should take control of the House of Representatives in the midterms, said Sage Eastman, partner at Mehlman Consulting. He predicted between 10 and 20 House seats would flip in the election. But the bigger question, he said, is what will happen in the Senate, and he believes Republicans will retain their edge.

Sometimes in an election year, “Congress acts like a lame duck and sometimes Congress comes together to clear the deck and pass something big – this isn’t the year,” Eastman said.

No 'galvanizing factor'

Eastman questioned whether Congress will try to reform the Affordable Care Act marketplace radically or whether to improve its efficiency. Another question is whether Congress will reform health savings accounts or continue to promote individual coverage health reimbursement accounts or choice accounts.

A small cohort in Congress is showing some interest in introducing another reconciliation bill, said Jane Lucas, partner at Alston & Bird. “But it doesn’t have a galvanizing factor in Congress,” she added.

On the health care front, Congress isn’t showing any impetus toward passing major legislation, said Lori Denham, partner and chief operating officer at KDCR Partners, although there is some activity on the committee level.

“I think when it comes to access, affordability and coverage, we will see some progress made regarding health care,” she said.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at susan.rupe@innfeedback.com.