The Trump Administration has introduced significant changes to healthcare policies, many of which will directly impact businesses and the healthcare options available to them in 2026. From Affordable Care Act (ACA) reforms to drug pricing policies and Medicaid restructuring, these actions are reshaping the healthcare landscape. Below, we explore the key changes and their implications for businesses, consumers, and the healthcare industry.
Affordable Care Act (ACA): A Shift in Accessibility
The Trump Administration has enacted policies that scale back some of the expansions made under the Affordable Care Act. One major change includes rescinding the extended enrollment periods for ACA plans and reducing funding for third parties that assist with enrollment. These actions are expected to decrease the number of people covered by marketplace plans. Furthermore, the administration proposes allowing enhanced ACA subsidies to expire at the end of 2025. Without congressional action, this could lead to higher premiums and out-of-pocket costs, reducing enrollment and increasing the uninsured population.
Drug Pricing Reforms: A Double-Edged Sword
The Trump Administration has taken bold steps to address prescription drug pricing, but not without controversy. By rolling back policies aimed at limiting drug spending by Medicaid and Medicare, the administration has shifted its focus to other strategies.
HHS announced it is taking steps to implement President Trump’s executive order on prescription drug pricing. The order impacts pharmaceutical manufacturers everywhere to align US prices for brand-name drugs. In addition it now requires no generic or biosimilar alternatives, aiming to establish “most-favored nation” pricing that the administration said will reduce the price of drugs between 30% and 80%. According to the The American Journal of Managed Care AJMC.
For example, President Trump signed an executive order to reduce prescription drug prices by aligning U.S. prices with those in other developed countries—a policy often referred to as “Most Favored Nation” pricing. While this aims to lower costs for consumers, cuts to research funding may hinder the ability of companies to bring new drugs to market. This creates a complex environment for businesses navigating drug development and pricing.
Medicaid Restructuring: Challenges Ahead
Medicaid has been a focal point for cost-cutting under the Trump Administration. Congressional Republicans are considering significant reductions to Medicaid funding, which could place financial burdens on states and jeopardize coverage for millions of Americans. Additionally, the administration may encourage states to implement work, training, or volunteer requirements for Medicaid recipients to maintain their coverage. These changes could increase administrative complexity for businesses and healthcare providers managing Medicaid patients.
Price Transparency: Empowering Consumers
A hallmark of the Trump Administration’s healthcare agenda is price transparency. Through executive orders, the administration has implemented regulations requiring hospitals and insurers to disclose actual prices for services. This move aims to empower consumers with clear and actionable pricing information and transparency. Which enables individuals to make informed decisions about their healthcare. Businesses, particularly those offering employee health benefits, may need to adapt to the increased demand for transparency and competitive pricing.
Artificial Intelligence (AI) in Healthcare: Uncertain Regulation
The Trump Administration has taken a cautious approach to regulating artificial intelligence (AI) in healthcare. By rescinding an executive order from the Biden Administration related to the safe and secure development of AI, the administration has signaled support for innovation but has left questions about oversight and regulation unanswered. Businesses leveraging AI in healthcare may face an uncertain regulatory environment as they innovate and expand their offerings.
Here’s what remains to be seen. Will AI now be helping humans to improve approvals for coverage? Will AI not take humans into account when making assessments for approved care for patients? Will AI be more arbitrary than human bias? Will AI have innate bias based on programing? These are things that we will need to monitor aa our country continues to navigate good applications for using AI.
Other Notable Changes Impacting Healthcare Options for 2026
Several additional actions by the Trump Administration are worth noting. A court has stayed on major changes to the ACA marketplace. There is an appeal in the works on behalf of the administration, causing a delay in policy that would restrict enrollment opportunities and increase consumer costs. The “One Big Beautiful Bill Act,” signed into law in 2025, is expected to have far-reaching implications for health coverage, though the specifics are still unfolding.
The administration has also announced plans to restructure federal public health agencies, including workforce reductions at the Department of Health and Human Services (HHS). Additionally, efforts to shorten FDA approval processes may accelerate the availability of new treatments but raise questions about long-term safety and efficacy.
Looking Ahead to 2026
At AUI we have seen so many changes roll out over the years. Each new season brings changes that will affect your healthcare options. What you had last year, might not be your best choice for next year. As new healthcare policies take shape, businesses must stay informed about their potential impacts on healthcare options and costs.
That is where the team of knowledgeable healthcare brokers from AUI come in. We help you simplify the complicated. From navigating changes to Medicaid and the ACA to adapting to price transparency regulations and drug pricing reforms. Your business will need to adjust your strategies to thrive in this evolving landscape.
You do not have to do this alone contact us today. Leverage AUI for open enrollment and beyond to keep up with all the moving pieces that affect your healthcare choices both as individuals and as businesses owners.
