Amy Niles, chief mission officer at the Patient Advocate Foundation, formerly known as the PAN Foundation, has outlined her vision for patient access reform in 2026.
Niles warns that while several healthcare policy changes this year bring genuine progress, two key decisions could have a detrimental impact on millions of Americans starting in 2026.
The mixed policy landscape means patients face both new opportunities and significant risks as major legislative and regulatory changes take effect across the healthcare system.
On the positive side, the Centers for Medicare and Medicaid Services will begin modernising prior authorisation procedures, including within Medicare Advantage plans.
The Improving Seniors’ Timely Access to Care Act is central to this effort, establishing an electronic prior authorisation process designed to improve the timeliness of care for patients.
Prior authorisation has long been criticised as a barrier to timely treatment, and the move toward electronic processes represents one of the more concrete steps forward in reducing administrative delays.
Beyond prior authorisation, Niles has called on Congress to reinstate enhanced premium tax credits for people enrolled in the ACA marketplace, so millions of Americans could afford their premiums and maintain health insurance.
The expiration of enhanced subsidies remains one of the most pressing affordability concerns, with patient advocates arguing that millions could lose coverage without legislative intervention.
The Patient Advocate Foundation’s proposed federal agenda also spans HELP Copays and Safe Step reforms, expanded Medicare coverage for telehealth, obesity care, and clinical trial access.
Telehealth expansion, in particular, has gained significant momentum in recent years, with patient groups arguing that continued access is essential for underserved and rural populations across the country.
Niles has positioned the Patient Advocate Foundation as an active voice in pressing lawmakers to act on these reforms before affordability gaps widen further throughout the year.
The organisation’s call for action reflects broader anxiety within the patient advocacy community that progress on access and equity could stall without sustained political commitment in 2026.