Federal Insights: January 2026

Affordability Becomes the Midterm Story: Both parties are positioning around "affordability" ahead of the 2026 midterms. The State of the Union on February 24 will offer President Trump an opportunity to refine competing narratives and more fully outline his full affordability agenda before first primaries begin March 3. Democrats will counter with their own housing and healthcare proposals. Whichever party owns the affordability story by spring shapes the legislative agenda, and quite possibly comes out on top in the midterm elections in November.

Partial Shutdown Likely Friday: Congress faces a Friday deadline to fund six remaining agencies accounting for $1.2 trillion in spending. Senate Democrats are blocking the package over DHS funding after Border Patrol killed Alex Pretti, a Minneapolis ICU nurse and U.S. citizen, on Saturday. This followed ICE killing another Minneapolis citizen, Renee Good, earlier this month. Democrats who voted to end November's 43-day shutdown are now refusing to fund DHS without accountability measures. The House is in recess until February 2, so any Senate changes require calling members back. However, Republicans see no incentive to separate DHS from the package, believing Democrats will be blamed for blocking a bipartisan deal.

ACA Subsidies Expired, Chaos Already Here: Enhanced ACA subsidies expired on December 31, 2025. The House voted 230-196 on January 8 to extend subsidies for three years, with 17 Republicans joining Democrats, but Senate action remains uncertain, even unlikely at this point. CBO estimates 2.2 million more Americans will become uninsured in 2026 without an extension, and insurers projected 18% median gross premium increases.

Even retroactive extension creates operational chaos. Systems must be reloaded, notices resent, shopping periods extended. Healthcare organizations should plan for three scenarios: no extension (current reality), one-year extension attached to an appropriations package or CR, or a multi-year extension in reconciliation later this year.

Interchange Fight Returns Via Faster Vehicles: Senator Marshall pulled a vastly expanded interchange amendment from the Agriculture Committee's crypto bill markup this week. But this is tactical retreat, not strategic abandonment. Watch for amendments to appropriations bills, the highway reauthorization (expires September 30), or this year's NDAA package. Institutions should model revenue impacts from interchange caps and get them in front of members - sooner than later.

Crypto Regulation Pushed to Spring: The Senate Banking Committee postponed its January markup of the Digital Asset Market Clarity Act (H.R. 3633) after the Coinbase CEO publicly withdrew support. The markup has been rescheduled for January 29, but the delay signals deeper consensus problems. The bill as currently drafted represents opening positions, but not final terms, signaling comprehensive crypto regulation likely pushes to spring or summer 2026.

The Pattern: Governance by crisis, policies decided by narrow margins, markets operating without regulatory clarity. For Oklahoma entities, federal instability compounds state uncertainty. Federal funding questions affect Medicaid expansion discussions, infrastructure projects, community resources, military installations, access to credit, housing inventory, and more. In 2026, the instability itself remains the story.