2026 – The Changes Could be Big
As I sit down to write the last blog of 2025, I want to take the time to wish everyone a great 2026 and hope you all took the time this holiday season to be with your loved ones and to recharge your batteries for 2026. Here at Seniors Speak Out we will continue to keep you up to date on what’s happening with healthcare for older Americans. I talked about some of the changes that happened last year in my last blog and I’m going to try to look forward and talk about 2026 and what we can expect. Many very smart people have warned me that trying to predict the future of healthcare policy is a fool’s errand, but I think it’s part of my job to make predictions and I’m the perfect fool to give it a try.
In my last blog I quoted Patrick Henry when he said that he had “no way to judge the future but by the past”. As we look toward 2026, I’m going to make this general prediction that the unexpected changes to our healthcare that happened in 2025 will continue. Now, before you critique me for my bold attempt at avoiding a meaningful prediction, let me explain. There is no doubt that no one predicted that the President would hire a billionaire to head-up an organization that had the power to end the jobs of thousands of government workers. No one thought that Robert F. Kennedy Jr., a former Democrat, would become the Secretary of HHS. I don’t think anyone could have predicted that 14 drug manufacturers would come to agreements with the President on drug prices in reaction to his Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients executive order. These all had, or will have, a profound effect on our healthcare and were very unexpected but they opened the door to possibilities and gave us a trajectory that we can use to look into the future.
It seems to me that last year there were a lot of unexpected incremental changes to many facets of our healthcare. I’ve often railed against these short-term, knee-jerk reaction type of changes. It seems are government is very good at the “penny wise, pound foolish” business. I think 2026 has the potential to see some more basic and long-term changes. While it gives me some hope, it also scares me since there is the possibility of both good and bad long-term changes. Here are some areas that I think will be open to some big changes.
Commercial Insurance – Whether the ACA’s enhanced premium tax credits get extended in the near future or not there is the possibility for some bigger changes in the commercial marketplace. While this doesn’t affect seniors directly it could have some effects on the availability of some medicines and services. The expanded use of health savings accounts is a concept I’ve liked for a long time, and it signals a willingness to incorporate some longer-term solutions into this marketplace.
Medicaid – The states will begin feeling the cuts to Medicaid and it opens the doors to other solutions. Work requirements and steps to reduce fraud and abuse have been discussed and have expanded the vision of how the government might regulate this program.
Artificial Intelligence (AI) – The promise of the increased efficiency of AI in healthcare diagnosis and delivery is tempered by the threat of over regulation, data security and bias in the database and model development. 2026 could be the first year where the value of AI is recognized and government oversight is solidified. How these two aspects of AI are implemented could have a big impact on how our healthcare is delivered.
Medicare Advantage – The fastest growing program in Medicare is Medicare Advantage (MA). There has been a substantial increase in how MA plans are monitored and regulated and it has caused a decrease in the number of MA plans available in some areas. I think the government will continue to change some rules and regulations which will impact the way MA plans get paid and the benefits they offer. While the fast growth of MA plans has resulted in some inconsistent billing, the basic concept of focusing on prevention and healthy living should not be stifled. The way to reward insurance companies for stressing prevention and early disease detection has always been a problem in the historical fee-for-service environment. We need to somehow find a way to expand the positive aspects of MA while ensuring billing integrity.
Continuing Innovation – 2025 continued the march toward threatening medical innovation. The impact of some of these policies is already being felt. I fear that the impact will accelerate in 2026. There are other countries who have already began luring innovators and ear marking monies to support innovation. Hopefully, our country’s leaders will recognize how important the biotechnology industry is to the U.S. and strive to reverse their course and work to help us maintain our world leadership in medical innovation.
I have a hope for 2026. I would like us to find a way to truly incorporate value-based care into our healthcare system. The current fee-for-service model perpetuates misaligned incentives, unnecessary costs, and gaps in patient-centered care. Value-based care rewards efficiency, preventative care, early disease detection and fair payments. It encourages competition and lowers costs. We’ve been trying to migrate to this better way to pay for healthcare for some time, maybe the time is finally right to really begin the transition.
I am looking forward to 2026, I think there is the possibility of some basic long-term changes that could have a profound impact on how our healthcare is administered. I wish you all a happy new year and hope you all succeed at every one of your new year resolutions.
Best, Thair