6 Things Older Adults Should Know About the New Spending Bill

A closer look at a few key health provisions and how they affect people 50-plus

Tony Pugh and Rachel Nania,

Updated February 03, 2026

AARP

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Published January 27, 2026

/ Updated February 03, 2026

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Congress on Feb. 3 approved a spending bill that includes several key health provisions that could affect adults 50 and older, such as extended telehealth services and new Medicare Advantage reforms.

The legislation, which was signed into law by the president, also provides funding for the Centers for Disease Control and Prevention, the National Institutes of Health, and other federal agencies.

Missing from the bill is an extension of the enhanced Affordable Care Act (ACA) premium tax credits that expired Dec. 31 and had helped lower monthly health plan costs for millions of Americans. Adults ages 50 to 64 often face premiums up to three times higher than those for younger adults.

Without the expanded credits, an estimated 4.8 million adults 50 and older with ACA coverage are expected to see higher premiums this year, AARP research shows. Despite its absence from the bill, AARP continues to fight to extend the enhanced ACA premium tax credits.

Any policy to reform or replace the health insurance marketplace is also not included. Meanwhile, a new report from the health policy nonprofit KFF finds that the cost of health care is becoming unaffordable for many, with two-thirds of the public (66 percent) saying they worry about being able to afford health care for themselves and their family.

Here’s a snapshot of six key provisions related to health that could affect older Americans:

1. Extension of Medicare’s telehealth services

The bill provides a nearly two-year continuation of Medicare’s enhanced telemedicine coverage, which began in 2020 to help keep older adults from being exposed to COVID-19 in hospitals and doctors’ waiting rooms. AARP supports permanent telehealth coverage, but this extension would expire at the end of 2027.

Telehealth services, also known as telemedicine, use the internet, video conferencing and wireless communications to provide health services remotely, removing the need for some in-person visits. The enhanced coverage has allowed patients to participate in telehealth appointments from their homes rather than going to a hospital or doctor’s office or to see a specialist remotely.

Recent Brown University research found that about 15 percent of all original Medicare beneficiaries had telehealth appointments in the first half of 2025, primarily to help monitor and treat chronic conditions. Nearly three-quarters of adults 50 and older said they used telehealth services at least once in the previous 12 months, according to a January 2024 AARP poll.

2. Continuation of a hospital-at-home program

The bill provides a five-year extension for this pandemic-era program that allows certain Medicare-certified hospitals to provide inpatient-level care at home. As of September 2025, 419 hospitals across 147 health systems and 39 states were approved to provide hospital-at-home services to Medicare patients.

The American Hospital Association says other health systems and hospitals have expressed interest in creating at-home programs but are hesitant to do so without a long-term extension from Congress. The at-home option is best suited for patients who need hospital-level care but are considered stable enough to receive care at home.

Based on pilot programs, the model could cut the cost of care by 30 percent or more in the U.S., according to the Commonwealth Fund, a New York-based nonprofit that supports research on health care issues.

3. Pharmacy benefit manager reforms

Pharmacy benefit managers (PBMs) oversee prescription drug benefits for health insurance companies. These companies have drawn intense scrutiny in recent years for certain business practices, such as favoring higher-priced medications with rebates that can be used to reduce premiums but may also benefit them financially, that regulators say contribute to higher drug prices.

Reforms included in the newly passed bill would improve transparency by establishing new reporting requirements for PBMs. The bill also establishes rules for their compensation and ensures it isn’t linked to drug rebates under Medicare’s prescription drug program (Part D).

About a quarter of older Americans have difficulty affording their prescription medications, a recent KFF poll found. About one-third of U.S. adults don’t take their medication as prescribed because of the cost.

4. Removal of bottlenecks in generic drug approvals

Generic drugs cost significantly less than brand‑name medications, but bringing them to market can be slow and difficult. And the public must wait at least nine years after federal Food and Drug Administration (FDA) approval before the cost of brand-name drugs can be lowered through Medicare price negotiations.

A provision in the new bill aims to remove a potential roadblock in the generic approval process by allowing the FDA to share more information with generic manufacturers to help them match a brand‑name drug. The change is designed to speed up approvals and increase competition and transparency in the pharmaceutical market.

5. Improvements to Medicare Advantage provider directories

Beginning in 2028, Medicare Advantage plans would have to verify the accuracy of their provider directories every 90 days. The bill also includes protections for patients who received treatment from providers incorrectly listed in a plan’s directory.

The measure reflects a growing concern with outdated “ghost networks,” which list providers who may no longer be in-network, practicing or accepting patients. A 2025 Health and Human Services Office of Inspector General report found the problem in numerous Medicare Advantage and Medicaid managed care plans.

6. Virtual options for Medicare diabetes prevention program

About 98 million U.S. adults — 1 in 3 — has prediabetes, a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. The risk for this condition increases with age.

However, lifestyle changes, including exercise and healthy eating, can help delay, or even reverse, a diabetes diagnosis. Evidence-based programs can help these behaviors stick, and a provision in the new bill would allow providers participating in the Medicare Diabetes Prevention Program to continue operating virtually.

The prevention program is covered under Part B for eligible beneficiaries who meet program health guidelines. The program includes 16 weekly core sessions, offered in a group setting over six months, that cover topics like weight control, exercise and motivational advice.

This list is not exhaustive: Several other parts of the bill support older adults, including $3 million for family caregivers, $4.6 billion for community health centers, and expanded coverage for multi‑cancer early detection tests.

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Tony Pugh is an award-winning writer and editor covering Medicare for AARP. He has also covered Medicare for Bloomberg Law and as a national correspondent for Knight Ridder/McClatchy Newspapers.

Rachel Nania is an award-winning health editor and writer at AARP.org, who covers a range of topics including diseases and treatments.