President Donald Trump signed H.R. 7148 in the Oval Office Tuesday and brought the Consolidated Appropriations Act 2026 to life. Photo: White House
President Donald Trump today signed H.R. 7148 — the Consolidated Appropriations Act 2026 bill — while surrounded by members of Congress in the Oval Office.
The new CAA 2026 statute contains thousands of provisions and $1.2 trillion in funding needed to keep much of the federal government operating normally.
Parts of the government began to shut down Saturday after the previous funding legislation expired.
The Senate passed the CAA 2026 package by a 71-29 vote Friday, and the House passed it by a 217-214 vote today.
The package includes three major provisions that would regulate pharmacy benefit managers, or the entities that manage health insurers prescriptionn benefits; funding for the Internal Revenue Service, the U.S. Securities and Exchange Commission and the U.S. Labor Department's Employee Benefits Security Administration; and many provisions that would extend current Medicare benefits and payment rules.
When the president asked the members of Congress if they wanted to comment on passage, Rep. Buddy Carter, R-Ga., a pharmacist who helped write the PBM provisions, said, "May I mention that there is significant health reform in this bill? PBM reform: Something that you have been working on, and that we appreciate and applaud your efforts."
The package also includes a provision that will extend the temporary expansion of Medicare telehealth benefits added in response to the COVID-19 pandemic, along with a section focusing on efforts to reduce maternal mortality rates, Carter said.
The president responded to Carter by talking about his administration's efforts to shift U.S. public health programs toward use of "most favored nation" pricing, or requirements that drug manufacturers offer Medicaid health plans the lowest prices that they offer in any rich nations in the world.
The president predicted that the most favored nations strategy will lead to big reductions in drug prices.
"We'll have the lowest price anywhere in the world," the president said.
The future: Senate Republican leaders won passage for the CAA 2026 package in the Senate by putting funding for the U.S. Department of Homeland Security, including DHS immigration enforcement efforts, in a separate bill. The CAA 2026 provides just 10 days of funding for DHS operations.
It's possible that efforts to provide DHS funding for the full year could lead to new opportunities for members of Congress to introduce and pass legislation related to health insurance, retirement savings or other matters.
President Donald Trump signed H.R. 7148 in the Oval Office today and brought the Consolidated Appropriations Act 2026 to life. Photo: White House
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