NABIP Legislative Update Week of 1/12/2026

The Senate and the House are both in session this week.

Healthcare Reform... Last week, the House voted 230 to 196 on a clean, three-year extension of Affordable Care Act (ACA) enhanced premium tax credits (EPTCs), with 17 Republicans crossing party lines to vote with Democrats. The same policy previously failed in the Senate, so this legislation is not expected to progress further. However, a bipartisan group of senators has been negotiating on the ACA subsidies with guardrails from Senate Majority Leader John Thune (R-SD), and the results of these negotiations could soon come to light. President Trump also met with House Republicans last week about healthcare more broadly, encouraging Republicans to take control of the healthcare conversation. TCG will continue to monitor the situation and will provide updates as information about an agreement on ACA tax credits or other healthcare developments becomes available.

Drug Pricing... Last week, Johnson & Johnson (J&J) issued a press release announcing a voluntary drug pricing agreement with the Trump Administration. J&J says the agreement "will allow millions of Americans to purchase medicines at significantly discounted rates" and provide the company with an exemption from tariffs. The press release provides only limited details, and specific terms of the agreement remain confidential. J&J stated it will participate in TrumpRx, provide Medicaid access at "comparable prices to other developed countries," and continue support for the Trump Administration's "efforts to ensure better recognition of the value of health care across developed markets globally." J&J is now the 15th company to announce an agreement on drug pricing with the White House; however, the press release notably was not accompanied by a press event, and the White House has not yet issued a fact sheet on the agreement as it did for others.

TCG Health Policy Spotlights...

·    Our Spotlight on the ACCESS Model and the TEMPO Pilot can be found here.

·    Our Spotlight on the House Republicans' year-end healthcare bill can be found here.

·    Our Spotlight on the BIOSECURE Act can be found here.

·    Our Spotlight on Republican healthcare affordability policy proposals can be found here.

·    Our Spotlight on the GENEROUS Model can be found here.

·    Our Spotlight comparing House proposals to extend ACA EPTCs and a bill tracker of ACA subsidy extension legislation can be found here.

UPCOMING HEALTHCARE HEARINGS

RECAP OF CONGRESSIONAL NEWS

·    1/6 the Congressional Budget Office (CBO) issued a report detailing how health insurance spending is measured in its series on the distribution of household income, which is intended to show the impact of fiscal policy on resources available to households.

·    1/7 Senate Finance Committee Ranking Member Ron Wyden (D-OR) released a report on how cuts to Medicaid and the loss of ACA enhanced premium subsidies will impact individuals with mental health concerns or substance use disorders.

·    1/8 the House passed a three-year extension of ACA EPTCs by a vote of 230 to 196, with 17 Republicans voting in favor.

·    1/8 the House Energy and Commerce Subcommittee on Health held a legislative hearing titled, "Legislative Proposals to Support Patient Access to Medicare Services." TCG's memo can be found here.

·    1/9 Senate Aging Committee Chairman Rick Scott (R-FL) released his priorities for the Committee for this year, including a strong focus on seniors' access to safe generic drugs.

RECAP OF ADMINISTRATION NEWS

UPCOMING HEALTH POLICY EVENTS

·    1/15/2026 and 1/16/2026 the Medicare Payment Advisory Commission (MedPAC) holds a public meeting.

·    1/22 at 10:00 PM the Centers for Medicare and Medicaid Services (CMS) Medicare Diabetes Prevention Program (MDPP) Team holds a webinar to discuss the Calendar Year 2026 Physician Fee Schedule Final Rule.

·    1/29/2026 and 1/30/2026 the Medicaid and CHIP Payment and Access Commission (MACPAC) holds a public meeting.

RELEVANT LEGISLATION

·    H.R. 6940. A bill to direct the Secretary of Health and Human Services to assess how Executive departments address mental health crisis prevention and awareness, and for other purposes; to the Committee on Energy and Commerce. Sponsored by Rep. Sheri Biggs (R-SC)

·    H.R. 6945. A bill to amend part A of title IV of the Social Security Act to clarify the authority of States to use funds for pregnancy centers, and for other purposes; to the Committee on Ways and Means. Sponsored by Rep. Michelle Fischbach (R-MN)

·    H.R. 6951. A bill to amend title XIX of the Social Security Act to repeal the requirement that States establish a Medicaid Estate Recovery Program and to limit the circumstances in which a State may place a lien on a Medicaid beneficiary's property; to the Committee on Energy and Commerce. Sponsored by Rep. Jan Schakowsky (D-IL)

REGULATORY UPDATE

Health Resources and Services Administration

Enrollment and Re-Certification of Entities in the 340B Drug Pricing Program (Notice)

Centers for Medicare and Medicaid Services

Opportunity for Hearing on Compliance of Minnesota State Plan Provisions Concerning Program Integrity and Fraud, Waste, and Abuse With Title XIX (Medicaid) of the Social Security Act (Notice)