The 2026 midterms have opened a door, as voters made clear that rising health care costs and threats to their coverage demand action. What we do next will determine whether that opening becomes meaningful change for people who need health care.
For the last two years, the National Health Law Program has stood as a bulwark against the Trump administration’s unlawful and harmful actions. Our responsibility was clear: stand with low-income families, people with disabilities, people struggling to make ends meet, and everyone this administration has left out, maligned, or targeted. We have fought to protect their access to health care, defend their civil rights, and advance health equity.
We challenged the administration’s purge of the federal government and joined allies determined to preserve the expertise and public institutions our communities depend on. We also welcomed public servants driven out by those attacks onto our own team, putting their knowledge to work in defense of health care.
We fought to stop the so-called One Big Beautiful Bill Act. We continue to contest its implementation and equip advocates to protect people from its harms.
We sued to demand transparency about the administration’s sharing of Medicaid enrollees’ personal information with immigration enforcement.
We joined amicus briefs defending the rights of people with disabilities and immigrants, access to ACA insurance plans, and funding for sexual and reproductive health clinics.
This fall, we filed the lawsuit Taylor v. Kennedy to challenge federal Medicaid work requirement rules that unlawfully narrow protections for people who are medically frail or have special medical needs, threatening health coverage for people with serious health conditions, including cancer, diabetes, HIV, and substance use disorders.
We strongly opposed the administration’s use of “waste, fraud, and abuse” as a pretext to freeze Medicaid and other social service funding. These actions sowed fear among working-class and low-income communities, immigrants, LGBTQ people, and people with disabilities, threatening essential services that help people stay healthy and make ends meet.
In states across the country, we defended sexual and reproductive health rights and helped expand access, including in Maryland and Virginia.
In California, we continued to lead efforts to protect the health care system that millions of people rely on.
This work has demanded resolve, expertise, and extraordinary partnership. It has also demanded the conviction that a better future is possible and a concrete plan to make that future real.
Now we must turn that conviction into action.
We will work with our partners and the new congressional majorities to advance legislation that reverses the trillion-dollar Medicaid cuts and restores the expired Affordable Care Act insurance subsidies. We will demand accountability for the harm already done and continue to challenge unlawful actions in court.
The most urgent work starts now. Federal law requires most states to launch Medicaid work requirements by January 1, 2027, and some already have. New governors taking office in January will shape how they are carried out. We will work with state partners and Medicaid applicants and enrollees to make sure no one who is eligible loses coverage to red tape. And we will hold states accountable when implementation fails the people it is meant to serve.
We continue our ongoing work to develop a proactive agenda for health reform, both internally and with partners.
We are also developing a Medicaid Repro Roadmap to expand access to sexual and reproductive health care. This spring, we will bring that vision to Capitol Hill and statehouses across the country, with practical proposals that move us toward a future where everyone can get the care they need.
An election does not restore someone’s coverage, reopen a clinic, eliminate discrimination, or erase the fear of seeking care. Those changes take sustained work. And rebuilding must mean reaching the people our health care system failed long before this administration took office.
NHeLP is ready for that work. We have defended the possibility of a better future. Together, we can build it. Join us in that future!
Jennifer Cannistra
Executive Director
National Health Law Program
