That Said

It looks like Congress continues to perfect the art of governing by deadline.  With more than a dozen pieces of health care policy – often called health care extenders – expiring on January 30, 2026, House Appropriations Chair Tom Cole released bill text on January 20 for a minibus that includes these health polices and a whole lot more. 

In this latest package, Congress is doing 3 things: 

1. They are extending the January 30 health care extenders, but not all for the same length of time 
2. They are authorizing new health programs but only temporarily – adding more health care extenders to the list 
3. They are also using this legislative vehicle for major policy reforms on pharmacy benefit managers (PBM) and organ drug exclusivity. 

Health Care Policy Extensions by Date 

So, let’s look at what health care policies Congress is extending.  We list them by date of extension. 

September 30, 2026 

Tennessee disproportionate share hospital payments 

December 31, 2026 

Community health centers 

National Health Services Corps 

Temporary Assistance for Needy Families program 

Public health emergency and national health security programs  

No Surprises Act implementation and funding 

Special diabetes programs 

Personal responsibility education 

Family-to-family health information centers 

Medicare dependent hospitals 

Low-volume hospital payment adjustment 

Work geographic practice cost index floor 

Medicare Part D coverage of certain authorized oral antiviral drugs 

September 30, 2027 

Medicare quality measurement support 

December 31, 2027 

Telehealth flexibilities 

Medicare outreach and enrollment support 

January 1, 2028 

Ground ambulance add-on payments 

September 30, 2028 

Medicaid disproportionate share hospital payment cut delay 

September 30, 2029 

Teaching health center graduate medical education  

September 30, 2030 

Hospital at home waiver 

March 1, 2033 

Medicare sequestration begins 

September 30, 2035 

Adjustment to Medicare hospice aggregate cap (was already extended through September 30, 2033) 

New Health Care Policy 

Now, let’s look at 35 new health care policies Congress is authorizing. 

Medicaid 

• Streamlined enrollment process for eligible out of State providers – effective date is 3 years after enactment 

• Removing certain age restrictions on Medicaid eligibility for working adults with disabilities – enactment after January 1, 2028 

• Medicaid State plan requirement for determining residency and coverage for military families – effective beginning January 1, 2030 

• State studies and HHS report on costs of providing maternity, labor, and delivery services – no later than 30 months after enactment and every 5 years thereafter for States; no later than 3 years after enactment and every 6 months thereafter for HHS 

Medicare 

• PBM reform 

• Extending Medicare’s Advanced Alternative Payment Model incentive payments and maintain adequate qualifying thresholds 

• Extending use of funds for Medicare hospice surveys through December 31, 2026  

• Telehealth for in-home cardiopulmonary rehabilitation from January 31, 2026 – January 1, 2028 

• Expanding definition of “aberrant billing patterns” for durable medical equipment – starting January 1, 2029 

• HHS Inspector General report on clinical diagnostic lab tests at high risk for fraud – due no later than January 1, 2028 

• Update guidance from HHS on telehealth for individuals with limited English proficiency – no later than 1 year after enactment 

• Inclusion of virtual diabetes prevention program suppliers in the Medicare Diabetes Prevention Expanded Model from January 1, 2026 – December 31, 2029 

• Outreach and education on medication-induced movement disorders – no later than January 1, 2028 

• GAO report on wearable medical devices – within 18 months of enactment 

• Adjustments to Medicare part D cost-sharing reductions for low-income individuals – starting in plan year 2028 

• Strengthening Medicare Advantage provider directory accuracy requirements – starting in play year 2028 

• Strengthening Medicare Advantage provider directory accuracy requirements – by plan year 2028 

• Medicare coverage of multi-cancer early detection screening tests – beginning January 1, 2029 

• Medicare coverage of external infusion pumps and non-self-administrable home infusion drugs – beginning the first calendar quarter that starts at least 1 year after enactment 

• Any willing pharmacy requirement – starting plan year 2029 

• Requiring a separate identification number and an attestation for each off-campus outpatient department of a provider – starting January 1, 2028 

• Revising phase-in of Medicare clinical laboratory test payment changes 

Public Health 

• Funding adjustments for the World Trade Center program  

• Maternal mortality best practices 

• Organ Procurement and Transplantation Network reforms 

• Federal living organ donor reimbursement program reforms 

• Federal Program for Pediatric Studies of Drugs through Fiscal Year 2028 

• Federal sickle cell disease program expansion through Fiscal Year 2030 

• Lifespan Respite Care Program through Fiscal Year 2030 

• PREEMIE network reauthorization through Fiscal Year 2030 

• Dr. Lorna Breen health care provider protection extension through Fiscal Year 2030

Food and Drug Administration 

• Changes application of orphan drug exclusivity to only the specific FDA-approved indication 

• Expansion of pediatric cancer drug development 

• Extension of rare pediatric disease priority review vouchers to September 30, 2029 

• Establishment of Abraham Accords Office within FDA 

Yes, that’s 35 new policies Congress is authorizing in this bill.   

Congress keeps jamming authorizing policy into appropriations bills, using must-pass funding vehicles to avoid resolving whether certain Medicare, Medicaid, and Food and Drug Administration programs should be modified, terminated, or permanently authorized.  Why does Congress keep doing this?  That’s a whole thing, and clearly a topic to delve into another day. 

What Now? 

Including health care extenders in this appropriations minibus is welcome news for health care providers who rely on these programs. However, this bill still needs to get through both houses of Congress and signed by the President before it can get into law. We’ve seen Congress appear to be close to a deal before on health care extenders only to trip at the last minute (i.e. the deal that came together and failed in December 2024).  

Regardless of the outcome of this package, keep this list of health policies handy.  Our analysis will either become a list of new health extender deadlines – or – it will provide a roadmap of bipartisan, bicameral support for the next health care legislative package. 

Even as the use of artificial intelligence (AI) in health care has been on the rise for years, federal policymakers are currently grappling with how to address the intersection of health care delivery, innovation, and AI regulation.

As AI becomes more integrated into health care operations and clinical decision-making, policymakers face the challenge of establishing frameworks that promote innovation while addressing concerns around bias, transparency, and accountability.

Through understanding the current federal landscape and the actions already taken, we can get a clearer picture of the direction policymakers and stakeholders are going and the implications for the health care system.

Federal Policy Actions

Recent federal involvement in AI policy is primarily driven by policymakers’ interest in:

• addressing concerns about regulatory gaps for AI use;
• establishing accountability measures for organizations that utilize the benefits of AI; and
• and improving public trust in AI systems to encourage responsible AI use.

In Congress, the Senate HELP Committee recently held a hearing on AI’s potential to support patients, workers, children, and families. The hearing showcased both support for the positive impacts of AI in various work sectors and concerns about the need for proper oversight.

Various bills have also been introduced, including:

• S.2997, the Right to Override Act, by Sen. Markey (D-MA)
• H.R.5045, the Health AI Act, by Rep. Lieu (D-CA-36)
• H.R.238, the Healthy Technology Act of 2025, by Rep. Schweikert (R-AZ-01)

These bills represent 3 different types of legislation related to AI and health care; those that seek to mitigate negative effects, those that seek to understand it better, and those that seek to utilize it to improve the health care system.

The Trump administration has also been active in the AI policy space, through its America’s AI Action Plan, which was published in July 2025. This plan encourages the development and use of new AI systems in health care.

Specifically, the Center for Medicare and Medicaid has proposed the WISeR Model, developed to review Medicare payments for certain services. Many stakeholders have concerns about the model, including the American Hospital Association (AHA), which recognizes the benefits of AI but is worried that the algorithm may ignore patient-specific care details without proper guardrails and human oversight.

Implications of Federal Actions

These actions represent early attempts at governing AI in health care and highlight the desire from policymakers to utilize AI to improve health care while negating potential adverse impacts. But how do these actions impact different stakeholders within health care?

Let’s start by looking at providers. We are already starting to see more AI platforms designed to increase efficiency for providers, but new regulations could require training modules and newly formed committees to monitor AI use in these settings, possibly increasing barriers to entry. Additionally, as AI use becomes more common in making care decisions, providers are raising concerns that regulations will not adequately protect their ability to use clinical judgement.

Drug manufacturers are seeing success with AI modeling to increase efficiency in the drug development process and could expand use to other aspects of manufacturing. The FDA has established the Center for Drug Evaluation and Research (CDER) AI Counsel to oversee these developments, however further guidance and action could bolster or limit AI use in the manufacturing process.

The AI Counsel has not finalized any guidance, as there are concerns about how AI is being defined, and how credibility and risk of different AI platforms can be established. Drug manufacturers have been supportive of AI use at the FDA so far, however there are concerns from within the industry about the technology providing incomplete and incorrect summaries which could lead to slowdowns in the approval process.

When it comes to patients, they are still skeptical about what health care in AI means for them. In a recent study published in JAMA, almost two-thirds of people surveyed reported distrust in their healthcare system’s use of AI and concern that AI could harm them.

This finding indicates a need for lawmakers to implement policies that increase confidence and trust in AI for patients to feel comfortable with ongoing AI use. This could require a change in approach from the Trump administration which has generally taken a view that stresses protecting AI innovation from overregulation.

Ongoing Policy Issues

While there has been movement regarding policies related to AI and health care, there are still some issues that will need to be addressed in the future.

• Equity and Bias: Some stakeholders, like the AHA, have expressed concerns that AI tools could possibly be biased or discriminate against patients, providing substandard care.
• Health Care Workforce: Both the AHA and the American Medical Association (AMA) have been supportive of expanded AI use to help address provider burnout, so long as it enhances providers’ work rather than replacing it.
• Oversight: The Biotechnology Innovation Organization (BIO) has previously stated that the organization supports an incremental approach to oversight and regulation to allow sufficient time for adaptation. The AMA emphasizes that providers must be included in oversight conversations to ensure that the technology is supportive for care.

What’s Next

AI in health care is no longer just a possibility; policymakers are actively grappling with its deployment for providers and payers. Decisions made now will impact how AI is utilized and perceived implicating access, quality, and cost of care for patients for years to come.