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Glenn Hunzinger, PwC’s Health Industries Leader, speaks with Kelly Griffin and Philip Sclafani about how the 2026 midterm elections may influence healthcare policy, regulatory priorities, and the pace of transformation across the industry. As policy direction becomes more fragmented across federal and state levels, healthcare leaders are navigating increasing complexity while continuing to respond to cost pressures and rapid innovation.
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We’ve summarized the discussion in a short Q&A so you can get the highlights in minutes.
Why do the 2026 midterms matter for healthcare policy?
Q. Glenn Hunzinger
Why do these midterms matter for healthcare—and what should leaders be paying attention to?
A. Kelly Griffin
The core forces shaping healthcare, including demographics, workforce constraints, and technology-enabled innovation, are already in motion and won’t be determined by a single election.
What elections do influence is pace. They shape which issues gain attention, how policy is enforced, and where operational friction shows up through regulation and funding.
Rather than driving sweeping reform, the midterms signal where the operating environment is heading. That helps organizations understand where risk is building and where opportunities for value creation may emerge.
What regulatory themes should leaders be watching?
Q. Glenn Hunzinger
If you had to narrow it down, what are the biggest regulatory themes right now?
A. Kelly Griffin
Three themes stand out: affordability, transparency, and the shift toward state-level action.
Affordability, especially total cost of care, is central to the policy agenda. It is showing up through tighter reimbursement, utilization scrutiny, and continued pressure to demonstrate value.
Transparency is also accelerating, with growing expectations for clearer insight into cost and accountability from both regulators and consumers.
At the same time, more activity is shifting to the states, creating greater variation and a more fragmented policy landscape.
What are you seeing across the industry right now?
Q. Glenn Hunzinger
What are you seeing play out across the industry—and how are you advising clients?
A. Philip Sclafani
This is one of the most dynamic periods in US healthcare in decades, with significant shifts across policy, legislation, and care models such as direct-to-patient.
At the same time, costs continue to rise, with medical inflation expected to reach 8 to 9 percent or higher and limited levers left to control it. Even with new models and policy changes, there is little that will meaningfully bend the cost curve in the near term.
In response, the industry is accelerating toward value-based care, exploring new reimbursement models, and rethinking traditional pricing structures. But affordability pressures continue to drive action across the entire system.
Where are organizations moving faster and where are they cautious?
Q. Glenn Hunzinger
Where are you seeing organizations move faster—and where are they still holding back?
A. Philip Sclafani
The pace of change has accelerated across the industry. Pharma is reshaping portfolios around IRA dynamics, building direct-to-patient models, and investing in domestic supply chains.
Payers and PBMs are moving away from rebate-driven models, and employers are beginning to rethink traditional purchasing approaches. Providers remain focused on margin, cost discipline, and operational efficiency.
At the same time, there is real optimism. AI is moving quickly from experimentation to impact, and many organizations see it as a catalyst arriving at the right moment to help navigate these pressures.
What does a more state-driven environment mean in practice?
Q. Glenn Hunzinger
What does this shift actually look like on the ground for organizations?
A. Kelly Griffin
As the federal government steps back from prescriptive national models, more responsibility shifts to the states, particularly in areas like Medicaid and coverage design.
This increases variation across markets while also elevating the role of consumers, who are making more decisions around plan choice and care engagement.
The result is a more distributed and geographically dependent risk environment. Success will depend on strong regulatory intelligence and flexible operating models that can adapt across states.
Are organizations underestimating or overestimating the impact?
Q. Glenn Hunzinger
Where do you think organizations are underestimating—or overestimating—what’s coming?
A. Philip Sclafani
Many organizations may be underestimating the operational burden of a fragmented, state-by-state regulatory environment. Compliance, licensing, and reporting requirements will continue to grow and become more complex.
At the same time, some are overestimating how long transformation will take. Technology and AI are accelerating change faster than expected and enabling new partnerships and business models.
A small group of organizations is already moving decisively, while others are still protecting legacy models. The gap is widening, but there is still time to act.
What should healthcare leaders prioritize over the next 6 to 12 months?
Q. Glenn Hunzinger
If you had to boil it down, what should leaders be focused on right now?
A. Kelly Griffin
Stay closely connected to both federal and state policy developments and turn that intelligence into action.
At the same time, embed scenario planning into core strategy. The goal is to operate effectively across a range of potential outcomes, not wait for clarity.
A. Philip Sclafani
Realign value to what is being rewarded today as incentive models continue to shift.
Build capabilities to operate in a more localized, fragmented environment.
And just as important, embrace a mindset that is comfortable making decisions with incomplete information while focusing on long-term value.
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