As 2026 begins, many forces, especially in changes to federal policy, are further shaping an already challenging landscape. With a one-seat Republican majority in the House, will compromise be the order of the day? That question looms, along with a key government funding deadline, and rising concerns about further impacts in access to care with the ACA tax credits expired. In our January Capitol Conversations webinar, we examined federal policy developments across our three priority areas — Medicaid, workforce, and health and housing — with a clear takeaway: decisions in Washington will have immediate, real-world impacts on providers and the communities they serve. Here are three key takeaways:
Medicaid and Behavioral Health: Medicaid remains a key focus, particularly as states move forward with implementing new work requirements and managing constraints on provider taxes, which in many states take effect later this year. Speakers also highlighted the recent reversal of SAMHSA grant cancellations that would have affected mental health and addiction treatment providers – and concern that we may see more sudden funding shifts ahead. Moreover, with Congress expected to finalize government funding by January 30 even with strong Democratic opposition to further funding for Immigration and Customs Enforcement (ICE), speakers emphasized close monitoring of funding decisions and the critical role of provider advocacy in shaping outcomes.
Workforce: Workforce shortages across health care and long-term services and supports continue to draw attention. Several immigration-related bills — including the Healthcare Workforce Resilience Act, Strengthening Our Workforce Act, Dream Act of 2025, and Dignity Act — aim to bolster the workforce while maintaining system integrity. While bipartisan interest remains, momentum may slow as midterm elections approach, making provider engagement especially important.
Health and Housing: Speakers discussed recent Department of Housing and Urban Development (HUD) disruptions related to Continuum of Care funding – although 12-months of continued funding is part of the Transportation and Housing funding bill, which is expected to pass. At the same time, speakers noted cautious optimism around the bipartisan Road to Housing Act, which could advance later this year and would strengthen coordinated, evidence-based responses to homelessness.
Across all issues, speakers stressed the importance of grounding advocacy in lived experience and maintaining strong relationships with policymakers. Now more than ever: stay engaged, stay informed, and stay grounded in your communities.
Kylie Bowlds is an Issue Education & External Relations Associate at Lutheran Services in America.