Predictions for 2026 on accountability, transparency and equity in U.S. healthcare by Elizabeth Mitchell, Keith Somers and more

In late December, we asked members of the Managed Healthcare Executive editorial advisory board and other analysts and leaders in healthcare to forecast the developments and trends that will leave their mark on U.S. healthcare in 2026. As we are now in the new year, here are some of the responses we collected.

Employers will be held more accountable as affordability crisis hits hard

We're predicting another double-digit increase for premiums. People are going to lose [the Affordable Care Act] subsidies. The affordability crisis is hitting hard, and it's real. I think that is absolutely critical. I will tell you we are focused on several pieces of legislation that we think have some potential. The Patients Deserve Price Tags Act and the Healthy Competition for Better Care Act, and there's a fair billing act. So I think those are three pieces of legislation that have some potential to make a dent.

I think you're going to see more and more accountability for the industry because of transparency, because of fiduciary pressure, and because of newly disclosed conflicts. The whole premise behind the CAA [Consolidation Appropriations Act of 2021 and the changes it made to the Employee Retirement Income Security Act] was that self-insured employers would hold the industry accountable. Well, we're increasingly going to have the tools and information to do that, and the pressure of the affordability crisis is going to sort of accelerate it.

Patients/consumer will demand visibility into value

In 2026, healthcare’s consumer revolution will accelerate. Patients will expect the same personalized, data-rich experience they get in every other industry: clear prices, transparent quality indicators and curated provider options. “Nearest to me” is no longer good enough. Consumers will demand visibility into value, including outcomes, access and cost.

Organizations that equip members with intuitive, comparable insights that combine price transparency with provider performance will win trust and loyalty. Those that do not will see patients shop elsewhere. The healthcare marketplace is officially open for informed choice.

The next phase of the Mental Health Parity Act will be implemented (it is hoped)

2025 was marked for the next phase of the Mental Health Parity Act, but it has been delayed until 2026. This is an important next step in achieving the goal of equitable care for the many suffering from mental health and substance use disorders because it places restrictions on health plans that may be limiting access to mental health services in a more restrictive manner than they would for medical or surgical benefits.

More importantly, it includes out-of-network services, which are crucial because individuals with mental health issues have an increased use of out-of-network care, which leads to higher out-of-pocket costs for patients. I remain optimistic that this next phase will be implemented given the incredible disparities present.

Doulas will become recognized as essential

In 2026, the U.S. will finally recognize doulas as an essential part of the maternity care workforce, not an optional add-on. Medicaid reimbursement is expanding, medical complexity during pregnancy is increasing, and families are demanding continuous, hands-on support, which means the era of the independent, unsupported doula model is coming to an end. We’ll see the rise of organized doula teams with real training, supervision and full-time employment structures that allow these professionals to collaborate directly with nurses, lactation consultants, mental health providers, and pediatric providers.

This shift will stabilize the workforce, improve birth outcomes, and bring long-overdue legitimacy to a role that has existed for thousands of years. At Mahmee, we’ve already begun building this model, and I expect 2026 to be the year the rest of the industry catches up.