The ACA’s Preventive Care Mandates Survived – But Enhanced Subsidies Set to Expire The Supreme Court gave the federal government the greenlight in June to continue enforcing the ACA’s preventive-care mandates. In a 6-3 bipartisan decision, SCOTUS rejected constitutional challenges brought to the structure of the US Preventive Services Task Force – but the Court’s rationale could potentially make the coverage rules more susceptible to political influence. However, the ACA’s enhanced premium tax credits are on track to expire at the end of 2025 – a heated policy issue that was largely to blame for the federal government’s longest-ever shutdown this year. Expiration of these ACA subsidies would cost healthcare providers more than $32.1 billion in lost revenue and a $7.7 billion spike in uncompensated care in 2026,” according to the Robert Wood Johnson foundation. FTC Warned Healthcare Employers and Staffing Firms Over Noncompetes The Federal Trade Commission announced in September that it had issued warning letters to several large healthcare employers and staffing firms, urging them to review their noncompete agreements and other restrictive covenants to ensure they are legally sound and don’t infringe on workers’ rights. We covered the biggest takeaways and a five-step compliance action plan.
2025 PREDICTIONS RECAP
HEALTHCARE
As we predicted, the Trump administration aimed to curtail the reliance on highly skilled workers and threw up roadblocks for employers who rely on the H-1B visa program. In September, Trump issued a proclamation imposing a $100,000 fee on new H-1B petitions – but after employers warned it could upend critical hiring pipelines in certain industries like healthcare, USCIS clarified several key points to provide relief to many employers. In addition, revocations of student visas (even if many were later restored) created uncertainty for hospitals and research institutions that rely on J-1 visa holders in training and clinical research roles. And the Trump administration’s reversal of a Biden-era policy that shielded healthcare facilities from ICE raids hit the industry hard, especially for nursing homes and home care agencies, according to this NYT article, due to “the critical role that foreign-born workers place in the long-term care industry.” Heightened Immigration Enforcement Impacted Industry While we correctly predicted that the Trump administration would roll back Biden-era NLRB rules, union activity did not stagnate in 2025. In fact, unionizations grew more popular among hospital workers nationwide, according to an Axios report, which cites “staffing shortages and worker burnout” as fueling the change. Strike activity among registered nurses and other healthcare workers hit employers hard this past year. Union Activity Did Not Die Down
PREDICTIONS FOR 2026
More Aggressive Scrutiny of AI Use As many healthcare companies begin using AI to generate clinical or other care-related notes, regulators may push for clearer guidelines around bias, patient safety, and data privacy – as we recently caught wind of in our interview with a key Virginia state lawmaker. Staffing Shortages and Workforce Pressure Will Intensify – and Create Other Problems
OUR PREDICTIONS WERE MOSTLY RIGHT
HOW DID WE DO?
Shortages will lead to increased use of staffing agencies. This will likely result in more misclassification claims, as some staffing companies hire workers as 1099s despite the significant risks of doing so in the healthcare space. If the DOL starts functioning at full capacity, we could see this becoming an area of increased scrutiny. Certain Types of Private Claims Will Keep Bringing Major Challenges Private litigation over independent contractor status will continue in home health, support services, and consulting roles, especially while we await a new DOL rule on the matter (though the new rule, which is expected to include a companionship exemption for home care employers, may ultimately face its own court challenges). We will also see a continuation of private claims by healthcare staff for working off the clock or while on break, or for unpaid overtime due to compliance challenges stemming from shift differentials or other extra pay models typically offered by healthcare employers to address staffing needs.
Hannah Sweiss Woodland Hills/Los Angeles Partner, Co-Chair
MORE FROM 2025 “Big Beautiful Bill” Brought Sweeping Changes to the Healthcare Industry President Trump signed a massive budget bill in July that will reduce federal Medicaid spending over a decade by an estimated $911 billion. The new federal law also blocks certain entities from receiving federal Medicaid funding through July 4, 2026 – which you can learn more about here. Some long-term care facilities may be relieved by the new law’s 10-year pause on a Biden-era final rule which had set new minimum staffing standards for long-term care facilities as a condition of participation in Medicare or Medicaid programs. The rule had already been tossed out by federal courts earlier this year.
Laurel K. Cornell Louisville Regional Managing Partner, Co-Chair
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