Genomic Answers for Children’s Health Act of 2026

• Children and families: Children on Medicaid who are suspected of having a genetic disorder, rare disease, or unexplained condition — including congenital anomalies, global developmental delay, or intellectual disability — would have whole genome sequencing and whole exome sequencing (WGS/WES) available as first‑tier tests in both inpatient and outpatient settings.
• Providers and laboratories: The bill defines WGS/WES to include sequencing plus analysis, interpretation, and data reports. It also requires payment for WGS/WES to be made separately rather than bundled with other medical assistance, clarifying billing and reimbursement.
• Federal oversight and implementation: The Department of Health and Human Services would conduct outreach, convene stakeholders, and publish a report within two years on state payment amounts, numbers of children receiving sequencing, outcomes, and related services. The Comptroller General would collect feedback and assess implementation, including prior authorization, workforce and reimbursement challenges for genetic counselors, and alignment with market costs, and make recommendations within two years.

The coverage and payment rules in the bill would take effect beginning January 1, 2027.