With midterm election season upon us and divided government likely waiting for us next year, any meaningful piece of healthcare legislation could be years away. This Congress left its mark on healthcare with $1T of Medicaid cuts from the One Big Beautiful Bill Act, as well as its decision not to extend the enhanced Affordable Care Act subsidies, but the health policy world can now shift its collective attention to the regulatory sphere. 
 
Outside of Health Secretary Kennedy and his personal projects, like vaccines and nutritional guidelines, policymakers at the Department of Health and Human Services (HHS) have pursued a focused agenda aimed at modernizing healthcare at the federal level. To combat ballooning healthcare spending, they have steadily advanced site-neutral payments, proposed cutting 340B payments, and introduced prior authorization to traditional Medicare. To facilitate technology adoption, they have taken a hands-off approach to AI regulation, while promoting and standardizing interoperability frameworks to allow developers better access to health data. Finally, and most (in)famously, they have made a big show of combatting fraud, increasing the funding for and salience of audits, while freezing grants they deem suspect. All of these efforts can continue without Congress, and also notably without about one fifth of the HHS workforce under President Biden. Certain parts of the federal government have been defanged through workforce and budget cuts, but HHS and its subdivisions remain on a mission.