Health care will get more expensive for some in 2026 – and cheaper for others

People covered by Obamacare and Medicaid may see health care costs rise, but for people on Medicare, Biden-era negotiated drug prices are set to go into effect.

A major health care divide is coming in 2026.

Some Americans may finally catch a break on rising costs, as the first negotiated Medicare drug prices go into effect. Others will end up paying more, as Affordable Care Act tax credits expire and Medicaid coverage becomes more uncertain amid drastic cuts in state funding.

The divide is the result of decisions made by the last two administrations. In 2022, President Joe Biden signed the Inflation Reduction Act, which for the first time gave Medicare the authority to negotiate prices on some of its most expensive prescription drugs. And in July, President Donald Trump signed the “big, beautiful bill,” which slashed funding for Medicaid and didn’t extend ACA subsidies.

“If you’re on Medicare, there’s some good news,” said Larry Levitt, executive vice president for health policy at KFF, a nonpartisan research group. “If you’re on the ACA or Medicaid, it may be bad news ahead for you.”

Starting Jan. 1, the first negotiated drug prices will go into effect for people with Medicare. These prices will apply to the 10 costliest drugs in the program, including the blood thinners Eliquis and Xarelto and the diabetes drugs Jardiance and Januvia. The drugs are used by nearly 9 million older adults.