Earlier this week the Chronic Disease Coalition board and Patient Advisory Council met to review trends in state and federal policy and to assess where the greatest risks—and opportunities—lie for chronic disease patients.
While our policy priorities remain grounded in Access, Affordability, and Representation, the general belief is that a significant amount of our time will be focused on protecting basic access to health insurance, especially for the most medically vulnerable.
Why Access Will Dominate the 2026 Landscape
States are already preparing for the substantial Medicaid cuts scheduled for 2027 under the One Big Beautiful Bill Act. Even before those reductions take effect, many states are tightening eligibility, applying stricter work requirements, or exploring new barriers to enrollment. As these changes move forward, the chronic disease and disability communities are at particular risk.
Many people with chronic kidney disease, autoimmune disorders, neurologic conditions, and other long-term health challenges simply cannot meet standard work requirements. And many more do work—often in part-time or unstable employment—while still relying on Medicaid or marketplace subsidies to maintain access to lifesaving treatment. Some diseases come on fast and are incredibly debilitating—we need to ensure those people too have the insurance they need for life-saving treatment.
Does health insurance matter? Common sense, and research, says yes.
In 2026, we will work closely with policymakers of all political backgrounds to ensure that disability exemptions are clear, medically accurate, and protective of patients. We will also continue to highlight the reality that chronic diseases are nonpartisan—and that the solutions must be, too.
A System Full of Promise—and Barriers
While new treatments and technologies are improving rapidly, the system that surrounds them is not always keeping up. From step therapy and prior authorization to the growing role of Prescription Drug Affordability Boards (PDABs), patients encounter delays and denials at multiple points in their care.
Some of these issues are regulatory and complex, and we’ll be working to explore them from the patients’ point of view. PDABs, for example, can have significant influence on access to medications for rare and chronic conditions; ensuring patients have a voice in those processes is essential (read our blog about it or our 2025 letter to Oregon’s PDABs). 340B is a federal program that is supposed to make medication more affordable for people with low incomes or those in rural communities. Unfortunately, too often it’s the hospital pharmacy that gets the discount, while the patient full price.
We have to make sure that discounts that are meant for patients actually gets to patients. That’s why representation in policymaking and regulation matters so much.
Sharpening Our Focus: What’s Ahead
In 2026, we will continue to respond to a broad array of issues. While we prepare to advocate especially for access to affordable health insurance, we’ll continue in our other priority areas.
Access to Care
- Step therapy
- Prior authorization
- Living donor protections
- Medigap
- Telehealth
- Non-emergency medical transportation
Affordability for Patients
- Copay accumulator bans
- PBM reform
- Alternative funding programs
- 340B transparency and preservation
Representation
- Health equity
- Rare disease advisory councils
- Chronic kidney disease task forces
Patients Lead the Way
As always, the most powerful voices in our advocacy are yours. Our ambassadors—now in 34 states and the District of Columbia —will help us identify new threats and opportunities as they arise.
For example: We did a recent poll of our Ambassadors to ask them what issues were most important to them. A clear answer rose to the top: CURES.
We responded right away by developing a letter to Congress, asking for the restoration of medical research funding. Read and sign the letter.
We also heard from our Ambassadors that they were worried about getting enough healthy food to manage their conditions and feed the children and elderly people in their families, so we developed a letter in support of SNAP. And even though the shutdown is over, the need for nutritious food continues and the letter is still relevant.
Staying Focused on What Matters
2026 will bring challenges, no doubt. But the Chronic Disease Coalition will continue to advocate for access to health insurance, affordability, and patient representation.
Chronic disease is nonpartisan. The solutions must be, too. And together—with patients, partners, and policymakers—we will ensure that every person living with a chronic disease has the care and coverage they need to live a healthy, stable life.