H.R. 7148 - Consolidated Appropriations Act, 2026

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This law provides funding for most federal departments and agencies for the remainder of fiscal year 2026. It includes appropriations for the Department of Defense, Labor, Health and Human Services, Education, Transportation, Housing and Urban Development, the Treasury, the State Department, and related agencies. The law also includes a temporary funding extension for the Department of Homeland Security through February 13, 2026, while Congress works on a separate appropriations bill for that agency.

A major focus of this law addresses how pharmacy benefit managers (PBMs) operate. PBMs are companies that negotiate drug prices on behalf of insurance plans. The law prohibits PBMs from earning money based on drug prices, rebates, or volume-based incentives when working with Medicare Part D prescription drug plans. Instead, PBMs can only receive flat service fees from drug manufacturers. These changes take effect in 2028. The law also requires PBMs to pass through all rebates they receive from drug manufacturers to the insurance plans, and to provide detailed reports about their compensation arrangements.

The law extends several healthcare programs that were set to expire. It continues Medicare telehealth services, allowing seniors to receive care through video or phone calls from expanded lists of providers. It extends hospital-at-home waivers for five years, allowing some patients to receive hospital-level care at home. The law also provides continued funding for community health centers and delays planned cuts to Medicaid funding for safety-net hospitals through 2028.

Additionally, the law includes reforms to increase transparency in how pharmacy benefit managers work with insurance plans and employers. It requires PBMs to disclose their compensation arrangements and rebate practices more clearly, and establishes new standards for pharmacy participation in Medicare Part D networks. These transparency measures aim to help patients and employers better understand how prescription drug prices are set and to reduce hidden fees that can increase out-of-pocket costs for patients.

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Consolidated Appropriations Act, 2026

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House Committee on Ways and Means

House Committee on the Budget

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Consolidated Appropriations Act, 2026

Summary

Lifecycle of the Bill

Lifecycle of the Bill

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Related Legislation (53)

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House Committee on Ways and Means

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House Committee on Appropriations