AHIMA Advocacy: A Recap of Washington’s Busy Summer

It’s been a busy several months in Washington, DC, as the Trump Administration and Capitol Hill have been busy moving ahead on their policy initiatives.

Regulatory Update

On the regulatory side, agencies have released and finalized numerous rules and are full steam ahead with a number of initiatives. Included in those rules are several Centers for Medicare and Medicaid Services (CMS) payment rules such as the calendar year (CY) 2026 Medicare Physician Fee Schedule proposed rule and the fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) final rule. This year, the IPPS final rule included the Assistant Secretary for Technology Policy/ Office of the National Coordinator for Health IT (ASTP/ONC) HTI-4 final rule, implementing policies to streamline electronic prior authorization and enable real-time prescription benefits.

CMS continues to be very involved in the US Department of Health and Human Services’ (HHS) work on health IT issues, most notably, a new Interoperability Framework and a call to action with voluntary commitments from industry partners to improve health data exchange and prioritize access to and sharing of information. The Framework was announced as part of the White House Make Health Technology Great Again event signaling increased interest in health technology from key Executive Branch leaders. HHS more broadly continues to move forward on the Make America Healthy Again initiative, with the most recent development being the release of the Make America’s Children Healthy Again Strategy Report, which built on the Make America Healthy Again Assessment and included strategic policy recommendations to address childhood chronic disease.

Finally, artificial intelligence (AI) continues to be another notable policy area many are watching closely. With the AI-related executive orders, Office of Management and Budget (OMB) memoranda, and AI Action Plan starting to implement AI-related policy, the industry is seeing a theme of pro-competition and pro-innovation with AI and encouraged development, testing, and evaluation of emerging AI tools. The National Institute of Standards and Technology (NIST) is also actively involved with developing national AI standards and soliciting feedback from stakeholders to ensure they reflect the needs of the community.

Impact of New Legislation

On Capitol Hill, Congress spent the summer working on two major legislative initiatives. The first was HR 1, a reconciliation bill with sweeping changes to Medicaid, Medicare, and the Affordable Care Act (ACA). Check out AHIMA’s fact sheet detailing all the potential impacts to healthcare here.

Among the many provisions included in the bill is a reversal of current law that prohibits Medicaid eligibility being conditioned on meeting work requirements. Beginning December 31, 2026, to be eligible for Medicaid, adults ages 19-64 will need to work or participate in qualifying activities for 80 hours per month, with exceptions for certain populations. Additionally, HR 1 provides a temporary payment increase under the Medicare Physician Fee Schedule of 2.5 percent effective for services taking place in 2026, and it increases restrictions on eligibility for ACA marketplace coverage to certain lawfully present immigrants beginning in 2028.

The second initiative was working toward the passage of the Fiscal Year 2026 (FY26) budget before the end of the fiscal year on September 30. However, due to opposing priorities between the Democrat and Republican parties, none of the 12 appropriations bills were passed before the end of the fiscal year. Multiple attempts to pass a continuing resolution (CR) also failed. These actions resulted in a complete government shutdown beginning October 1 at 12:01am ET. As of this publication date, it is unclear how long the shutdown will last or what concessions will be made by one or both parties in order to bring about the eventual passage of a CR that would reopen the government and provide Congress with enough time to pass the FY26 budget.

To learn more about how the government shutdown and lapse in federal funding will impact various government functions, view the AHIMA 2025 Lapse in Appropriated Government Funding FAQ. The coming months will hold many developments from both federal agencies and Capitol Hill, so be sure to stay in touch through our HI Advocate Newsletter and remember to register and tune in for the next Washington Update webinar on December 9 at 1 p.m. ET.

A recording of the Washington Update webinar discussing these updates as of September 10is available on-demand for free.

Caterina DeBarros, MPP, is Manager, Government Affairs, at AHIMA, and Tara O'Donnell, MPH, is Manager, Regulatory Affairs, at AHIMA.