Consolidated Appropriations Act, 2026

It pairs line‑item dollar totals with policy changes that reshape Medicare and Medicaid rules, require new pharmacy benefit manager transparency and pass‑throughs, boost NIH/CDC and public‑health grants, tighten DoD procurement and domestic sourcing, and set detailed country‑by‑country foreign assistance conditions.

• Families, patients, and seniors see changes to Medicare and Medicaid policy along with large program funding, including state Medicaid grants of about $508.1 billion and Medicare HI/SMI payments near $593.8 billion. Telehealth and Acute Hospital Care at Home flexibilities are extended and new multi‑cancer early detection coverage phases in beginning 2029.
• Communities, renters, and local projects receive housing and infrastructure investments, such as the Community Development Fund around $7.0 billion and the HOME program about $1.3 billion. Tenant‑based vouchers, public housing health and lead grants, and FAA/highway grant lines back workforce and local construction.
• Service members, the defense industrial base, and allied partners face detailed DoD procurement, multiyear contract limits, domestic sourcing rules, and targeted security aid including a $1.0 billion Taiwan initiative and $500 million for Israeli cooperative programs. Transfer, reporting, and Buy American rules shape execution across the department.