This week, Congress passed its annual budget reconciliation package that boosts immigration enforcement by another $70B, after using that legislative vehicle cut Medicaid spending by $1T over a decade last year. That means Congress is all but officially done passing meaningful legislation for the year, and healthcare has been left to the wayside. The only bills left in contention are annual appropriations to fund the government by October 1, but recent precedents in election years suggest Congress will pass stopgap measures to maintain current funding levels until after the midterms. This includes the House Appropriations Committee’s recently passed measure to ban Medicare from implementing the WISeR prior authorization model, which would only become law once HHS is funded for 2027. Congressional action on Trump’s Great Healthcare Plan, pharmacy benefit manager reform, site neutrality, and any other smaller priorities will have to wait until the next Congress, which is likely to produce a divided government, should Democrats take the House or Senate. With Congress looking out at years of potential gridlock, the regulatory agenda of the Trump administration will bear the load of healthcare policymaking.