October 7, 2026
Health Policy Report – October 7, 2026
House Democrats Outline Agenda for First 100 Days of 120th Congress
In a memo to House leadership, the House Democrats’ Cost-of-Living Healthcare Working Group outlined a legislative roadmap if Democrats take the House majority in the next Congress.
The document highlights the need to move quickly to overturn healthcare cuts in the One Big Beautiful Bill Act (H.R. 1), reinstate the enhanced Affordable Care Act (ACA) tax credits, eliminate medical debt, cap Medicare out-of-pocket costs, and more. The memo highlights a list of legislation that Democrats hope to advance and includes the Patients First Act (H.R. 9693), which would establish more sustainable physician payment updates under Medicare.
The working group also outlined a first-year agenda that would lay the groundwork for universal health coverage. “Members of the Democratic Caucus hold a diversity of views on how to achieve universal coverage including Medicare for All, strengthening and expanding ACA subsidies, closing the Medicaid coverage gap, lowering the age of Medicare eligibility, and creating a robust public option available to every American,” the group wrote.
To read the memo, CLICK HERE.
CMS Finalizes GLOBE Model as All 50 States Join GENEROUS Model
On September 30, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for the Global Benchmark for Efficient Drug Pricing (GLOBE) model. The model aims to apply most favored nation pricing in Medicare Part B and will run for five years from Jan. 1, 2027, through March 31, 2032.
The final rule was significantly narrowed from the proposed rule, excluding orphan-only drugs, CNG therapies, drugs with an Inflation Reduction Act maximum fair price, and pharmaceutical manufacturers that participated in the GENEROUS model or that previously made separate most favored nation deals with the Trump administration. As a result, Medicare actuaries estimate the model’s estimated savings have been reduced from nearly $12 billion in the proposed rule to $440 million.
The final rule follows a recent announcement that all 50 states have submitted applications to join the GENErating cost Reductions fOr U.S. Medicaid (GENEROUS) Model. The model, launched at the beginning of the year, aims to reduce the price of drugs for Medicaid beneficiaries by aligning them with prices paid by other countries. Under the model, participating drug manufacturers will agree to offer lower prices to state Medicaid programs.
To read more about the GLOBE model, CLICK HERE.
To read more about the GENEROUS model, CLICK HERE.
Milliman Releases New Report on IRA Impact to Medicare Part B Drugs
In a new report commissioned by the National Infusion Center Association (NICA), the Milliman Institute examined the impact of the Inflation Reduction Act’s (IRA) Medicare Part B changes on non-oncology drugs.
The report concluded that the IRA would decrease provider reimbursement for non-oncology drugs by $9.2 billion over ten years. The Milliman Institute noted that providers may respond to these losses in different ways, potentially offsetting losses through other revenue streams, ceasing to offer selected therapies, reducing staffing, merging with larger health systems, or even shutting down.
“Although some of these providers may be able to absorb margin reductions elsewhere, for others the margin reductions may affect their ability to remain in operation. Disruption to these providers’ ability to provide care or remain in operation could, in turn, disrupt patients,” the report noted.
The report noted that the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299), if passed, would restore $9 billion of these projected losses.
To read the report, CLICK HERE.
Support Continues to Grow for H.R. 4299
As lawmakers begin to consider options for a potential end-of-year healthcare package, efforts to advance the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299) are gaining steam.
Over the last few months, third-party voices have emphasized how changes to Medicare Part B reimbursement could jeopardize patient access and undermine competition. From an op-ed by Dr. Wayne Winegarden in the Washington Times to an op-ed from David Flemming from the Wyoming Liberty Group, our message is being heard by lawmakers in Washington and in their own backyards.
This has complemented media engagement from Network physicians, who have been thanking co-sponsors of this legislation through op-eds and letters to the editor in their hometown papers. Most recently, Dr. Sara Robinson of Rocky Mountain Cancer Centers (RMCC) penned a letter to the editor in response to David Flemming’s op-ed, highlighting how her Colorado practice sees multiple patients from Wyoming who can’t otherwise access community-based care. She thanks Senator Barrasso for his leadership on H.R. 4299 and urges lawmakers to advance the legislation this year.
Meanwhile, Patients and Providers United continues to engage physician and patient advocates through its website and social media platforms. In the most recent installment of Patients and Providers United’s video series, Dr. Jennifer Gordon highlighted the far-ranging benefits of community oncology for patients and explained why preserving access to this care is so critical.
The Network will continue to build upon these efforts in the remainder of the year and work to advance H.R. 4299 this Congress.
To read Dr. Winegarden’s op-ed, CLICK HERE.
To read the Wyoming Liberty Group op-ed, CLICK HERE.
To read Dr. Robinson’s LTE, CLICK HERE.
To view Patients and Providers United’s website, CLICK HERE.
To watch Dr. Gordon’s video, CLICK HERE.
The Network Meets with Key Members of House Energy & Commerce Committee
The Network recently met with Chair of the House Energy & Commerce Committee Brett Guthrie and Congressmen Troy Balderson, Randy Weber, August Pfluger, and Russ Fulcher to discuss the value of community oncology.
During the meeting, Jason Hammonds, President of Oncology & Multispecialty, Andrew Jackson, Texas Oncology, Ben Jones, Senior Vice President of Government Relations & Marketing, and Angela Storseth, Vice President of Government Relations, highlighted the need to advance the Protecting Patient Access to Cancer and Complex Therapies Act (H.R. 4299) this Congress to protect access to high-quality, affordable cancer care.
Momentum Builds to Address Medicare Physician Pay
Patient and physician groups are increasing pressure for legislators to advance the Patients First Act, which would reform the Medicare Physician Fee Schedule (MPFS) and link annual pay updates to inflation.
The legislation received bipartisan support in a recent House committee hearing. The proposal has also received support from dozens of physician and patient groups, including The Network, The American Medical Association, American Academy of Family Physicians, American College of Physicians, and the American Osteopathic Association.
Congress is out of session until after the midterm elections, but these recent efforts have laid a strong foundation for changes to Medicare physician pay. While it is still uncertain whether the entirety of the Patients First Act will pass this Congress, experts anticipate that lawmakers will consider a short-term fix to offset the proposed payment cut for 2027.
To read more, CLICK HERE.
Senate HELP Committee Holds Meetings on Key HHS Posts
The Senate Committee on Health, Education, Labor, and Pensions (HELP) recently held two meetings on key HHS leadership posts.
On September 24, the committee held a confirmation hearing on Dr. Heidi Overton’s nomination as commissioner of the Food & Drug Administration. During the hearing, senators questioned Dr. Overton on a range of health issues, from vaccines to food safety. A vote on her nomination is forthcoming.
On September 30, the committee voted to advance the nominations of Dr. Nicole Saphier to be Surgeon General of the Public Health Service, Dr. Timothy Westlake to be Assistant Secretary for Mental Health and Substance Use, and Mary Lazare to be Assistant Secretary for Aging.
To watch the Senate HELP confirmation hearing, CLICK HERE.
To read more about the nominations of Dr. Saphier, Dr. Westlake, and Mary Lazare, CLICK HERE.