Health Headlines: January 2026

On January 22, 2026, the House of Representatives passed HR 7148, an appropriations package that would finance the U.S. Department of Health and Human Services and other agencies. The bill includes pharmacy benefit manager (PBM) reforms, including delinking PBM compensation from drug list prices in Medicare Part D beginning in 2028, increasing reporting requirements for both plan sponsors and the federal government, and requiring PBMs to pass through negotiated savings to employer health plans under new or renewed contracts. Lawmakers and advocates argue these changes will help reduce incentives for PBMs to favor higher-priced drugs and improve price transparency for patients and plans.

The broader package also includes a range of health-related provisions. It would boost funding for community health centers, extend several expiring programs such as special diabetes programs and teaching health centers’ graduate medical education programs, and temporarily delay cuts for Medicaid disproportionate share hospitals. Other bill elements target pricing transparency and payment structures, including requiring separate identification numbers for hospital outpatient departments to curb higher facility fees, tripling funding for implementation of the No Surprises Act, and renewing various Medicare payment programs with updated timelines.

As previewed in our December 2025 newsletter, on January 8, 2026, the House of Representatives passed HR 1834, extending expanded tax credits to subsidize Affordable Care Act (ACA) health plan premiums. The ACA open enrollment period for 2026 ended before the bill was passed in the Senate. According to its January 2026 cost estimate, the Congressional Budget Office (CBO) expects the impact of the bill, if passed by the Senate, to be minimal this year since premiums have already been set for the 2026 open enrollment period. It estimates 100,000 additional Americans would enroll in insurance plans subsidized by the expanded tax credits during other special enrollment periods throughout the year. It also projects that the extended subsidies’ impact would peak in 2028, with an additional 4 million Americans enrolling in insurance and premiums decreasing by 9%. The CBO expects the bill to increase the federal deficit by nearly $80.6 billion over the next 10 years.

As discussed in our December 2025 newsletter, the U.S. Department of Health and Human Services (HHS) 340B Rebate Model Pilot Program, which would allow certain pharmaceutical manufacturers to provide rebates after sale rather than through traditional up-front discounts, was blocked by the U.S. District Court for the District of Maine after hospital groups challenged its legality under the Administrative Procedure Act. A federal appeals court refused to stay that injunction in early January 2026, keeping the pilot on hold while litigation proceeded.

The U.S. Court of Appeals for the First Circuit dismissed the HHS’s appeal of the injunction after the parties agreed to voluntarily drop it — signaling that the HHS may reconsider and revise the pilot’s underlying approvals through the notice and comment administrative process. Previously, the HHS and hospital groups had been in discussions about returning the challenged approvals to the Health Resources and Services Administration for reevaluation, a move that would leave the long-standing up-front discount model in place while the agency potentially revises its approach.

On December 31, 2025, the United States Drug Enforcement Administration (DEA) announced the fourth temporary extension of COVID-19-era telemedicine flexibilities for telehealth prescription of certain controlled substances through December 31, 2026. The “Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” allows registered practitioners to continue to prescribe Schedule II–V controlled substances via telehealth without an initial in-person visit. The extension was announced the day before the flexibilities were set to expire on December 31, 2025, though the DEA had signaled in November 2025 that it was likely to maintain the status quo with an extension through 2026. The DEA extends the telemedicine flexibility in an effort to “protect patients, expand access to care, and close the door on diversion into the illicit drug market” while it promulgates a final rule for the future of telehealth prescriptions of controlled substances. Goodwin will continue to monitor any developments in the final rulemaking.

Along with the extension comes the implementation of two other controlled substance rules, initially published in January 2025. The “Expansion of Buprenorphine Treatment via Telemedicine Encounter” rule allows practitioners to prescribe patients an initial six-month supply of buprenorphine, a well-regarded opioid use disorder treatment, without an initial in-person visit with the patient. The “Continuity of Care via Telemedicine for Veterans Affairs Patients” rule allows U.S. Department of Veterans Affairs practitioners to prescribe Schedule II–V controlled substances via telehealth without an initial in-person visit, so long as another Veterans Affairs practitioner previously conducted an in-person evaluation of the patient.

Republicans Call to Reinstate In-Person Dispensation Requirements for Mifepristone

This month, the Senate Committee on Health, Education, Labor and Pensions held a hearing regarding the in-person dispensation requirements for mifepristone, a U.S. Food and Drug Administration–approved prescription medication used for first-trimester abortion and the management of early pregnancy loss. In January 2023, the Food and Drug Administration removed in-person dispensation requirements for the medication, which enabled mifepristone to be prescribed through telehealth and dispensed by qualified retain pharmacies and by mail. This came after the in-person dispensation requirements had been temporarily lifted during the COVID-19 pandemic to improve patient access and reduce healthcare system burdens.

Now, Republicans are calling for the reinstatement of the in-person dispensation requirements, asserting that their lack has led to negative health outcomes for patients taking the medication and those taking the drug beyond the appropriate gestational period. Democrats, on the other hand, have emphasized mifepristone’s proven safety and efficacy and characterized Republicans’ efforts to limit access as an attempt to further restrict abortion care following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. Following the hearing, Republicans requested further safety reviews of mifepristone, which the U.S. Department of Health and Human Services has indicated are ongoing.

Supreme Court of Wyoming Upholds Permanent Injunction of State Ban on Medication Abortion

In 2023, Wyoming passed two restrictive abortion laws. This month, the state’s highest court held that they violate its constitution.

The two abortion laws at issue are the Life is a Human Right Act (aka the Life Act, enacted as Wyo. Stat. Ann. section 35-6-120 et. seq.) and the Medication Ban (enacted as Wyo. Stat, Ann. section 35-6-139). The Life Act prohibits the provision of abortion care, and the Medication Ban makes it illegal “to prescribe, dispense, distribute, sell or use any drug for the purpose of procuring or performing an abortion on any person,” and both have certain exceptions.

In State v. Johnson, the plaintiffs, who are healthcare providers and women of reproductive age, challenged these laws. They sought a declaration that the laws violate Article 1, Section 38 of the Wyoming Constitution, which guarantees “each competent adult […] the right to make his or her own health care decisions” and directs the state and its judicial branch “to preserve these rights from undue governmental infringement.” The plaintiffs also sought a temporary restraining order, preliminary injunction, and permanent injunction enjoining any enforcement of the two laws. The lower court granted a temporary restraining order and later granted summary judgment to the plaintiffs, finding that the laws do violate the state constitution and entering a permanent injunction enjoining their enforcement.

The state appealed the lower court’s decision; on January 6, 2026, the Supreme Court of Wyoming upheld it, finding that abortion is healthcare and thus decisions regarding abortion care are protected under the state’s constitution. The Supreme Court held that the state had not shown that the laws were “narrowly tailored to serve a compelling government interest” (but did not decide whether the state did, in fact, have any such compelling interest) “without unduly infringing on a woman’s fundamental right to make the health care decision to have an abortion,” and thus the laws “do not constitute reasonable and necessary restrictions” on the right to make one’s own healthcare decisions.

Texas State Court Finds that Planned Parenthood Has Standing to Challenge the State’s Heartbeat Act

This group has written previous periodic updates regarding Senate Bill (SB) 8, the Texas Heartbeat Act, which was enacted in 2021 and bans abortions once a fetal heartbeat is detected (approximately six weeks after conception).

Instead of imposing any penalty for violations of the law, SB 8 authorizes private citizens to enforce its provisions through civil lawsuits. This law has been widely challenged, including through 14 lawsuits against Texas Right to Life (TRTL), a Texas antiabortion organization, and John Seago (its former legislative director, now president) relating to their enforcement of the law. The 14 lawsuits were brought by various organizations and individuals involved in the provision of abortion care in Texas, including Planned Parenthood, and were, as a group, referred to a multidistrict litigation panel (the MDL Court). The MDL Court denied TRTL’s motion to dismiss, which TRTL appealed to the Texas Court of Appeals.

On January 16, 2026, the Texas Court of Appeals found that the plaintiffs had shown that they had suffered an injury in fact (the civil litigation threatened by Texas Right to Life to enforce SB 8) and that the injury is “both concrete and particularized and actual and imminent.” The court found that the defendants were thus the appropriate parties to sue in this action and that, even “when the enforcement of the statute has been delegated by the state to private citizens,” the plaintiffs did not need to wait to be subject to penalties under SB 8 to seek relief. After finding that the plaintiffs did have standing, the court affirmed the MDL Court’s denial of TRTL’s motion to dismiss, thus allowing the lawsuit to proceed.