On January 1, 2026, millions of Americans opened their health insurance renewal notices to discover their monthly premiums had more than doubled. A family in Ohio paying $350 per month in 2025 now faced a $780 bill. A self-employed consultant in Arizona saw her premium jump from $287 to $615. Congress had allowed government help paying for health insurance to expire, and roughly 24 million people immediately felt the impact in their bank accounts.

This affordability crisis sits at the center of Congress’s 2026 agenda. The tax code changed substantially when President Trump signed the One Big Beautiful Bill Act on July 4, 2025. Surface transportation funding expires September 30, threatening hundreds of billions in infrastructure projects. Medicaid work requirements take effect in 2027, and states are scrambling to implement them. All of this unfolds against the backdrop of November midterm elections that could flip control of Congress and end the Republican legislative agenda entirely.

The next ten months will determine how much you pay in taxes, whether you can afford coverage, and whether your state gets federal money to fix crumbling highways. Some of these changes are already law. Others remain dependent on whether Congress can pass a second special budget bill that needs fewer votes to pass before the election calendar makes ambitious legislation impossible.