Congress scrambles on health priorities, but most will stall

Modern Healthcare – Tuesday, January 20, 2026
By Michael McAuliff

As Congress approaches another funding deadline at the end of the month, lawmakers across Capitol Hill are jockeying to get their healthcare priorities addressed — but most seem resigned to seeing only the most essential measures pass this time around.

Bills that Congress must approve by Jan. 30 include extensions of telehealth and hospital-at-home authorities under Medicare and expiring funding for community health centers and dozens of other programs.

Traditionally, lawmakers take advantage of must-pass legislation to attach other bipartisan bills that they would like to move. There is a pile of healthcare legislation that could fall into that category, including measures regulating pharmacy benefit managers, health insurance prior authorizations and transparency across the sector.

PBM bills in particular have been a focus of internal discussions lately, lawmakers and staffers said, but even the chair of the powerful Senate Finance Committee, Sen. Mike Crapo (R-Idaho), couldn’t promise reporters that widely supported, bipartisan PBM legislation would ride along with the spending bills.

Not only are congressional appropriators attempting a bipartisan deal on government funding for the remainder of fiscal 2026 that they are loath to jeopardize with extraneous items, but the sheer number of healthcare bills would make that unmanageable in a short time frame.

“There’s a lot of moving parts,” Crapo said Thursday before the Senate recessed for a week.

With PBM legislation specifically, Crapo suggested it is so popular it could end up being the engine that drives other health items forward.

“It’s generally finding a vehicle or determining whether it will become a vehicle. And there’s so many other healthcare negotiations,” Crapo said.

Several lawmakers said they didn’t think a bunch of healthcare priorities would make it into funding legislation, even though the bill that finances the Health and Human Services Department hasn’t yet passed either chamber, since it is one of the most contentious.

Instead, the notion of keeping government funding simple and trying a standalone healthcare package later is gaining traction among Democrats and Republicans, many of whom are still smarting after the White House spiked a major bipartisan health bill just over a year ago.

“We need a healthcare package,” said Sen. Dr. Roger Marshall (R-Kan.), pointing to PBMs and telehealth as key priorities.

Sen. Tammy Baldwin (D-Wis.), a member of the Senate Health, Education, Labor and Pensions Committee as well as the top Democrat on the subcommittee in charge of HHS funding, suggested HELP Committee Chair Sen. Dr. Bill Cassidy (R-La.) could spearhead that work.

“There’s still some hope that Chairman Cassidy in HELP will take up some of the bipartisan ideas that passed last session, but didn’t make it through the entire process,” Baldwin said.

Other Democrats were hopeful of a package, as well, but suggested Republicans seemed to be having a difficult time unifying on health proposals, even the bipartisan ones that Congress has advanced before.

“We just had our second hearing in the health subcommittee since September, so I really don’t have any idea what the Republican majority is doing,” said Rep. Diana DeGette (D-Colo.), the ranking member of the Energy and Commerce Committee’s Health Subcommittee. “There are many bipartisan bills that impact patients,” she said.

DeGette, like many colleagues, wanted to first make sure there are no funding or legal lapses like during the government shutdown last fall, which stranded community health centers and interrupted telehealth and hospital-at-home service for Medicare beneficiaries.

Whether other items can move forward will become clear soon, likely when the Senate returns on Jan. 26 with just four days remaining to finish the government spending package.

Anything left out of that legislation would be fodder for a healthcare package that has proved difficult to advance, despite being widely desired. Lawmakers declined to speculate on the odds during an election year, when politics often complicates even bipartisan efforts.

The chances of cooperation could dim if President Donald Trump attempts to push for elements of his newly proposed health plan. At a news conference Friday, Trump and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz suggested Republicans may pursue the same partisan process Republicans used to pass Trump’s tax law in the summer.

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