The last year has seen several waves of federal policy updates and legislative moves that have significantly impacted the world of medicine.
With 2025 drawing to a close, John Donovan, MD, a physician at Willamette (Ore.) ENT & Facial Plastic Surgery, joined Becker’s to discuss the federal policies he will be watching most closely in the new year.
Editor’s note: This response has been lightly edited for clarity and length.
Question: What federal policies are you watching most closely in 2026 and why?
Dr. John Donovan: 1. The insurance companies receive funds to double-cover veterans who have 99% of their care through the VA. This is a waste of funds.
2. Any relief from pre-authorization requirements from insurance companies. This is a waste of office staff. This PA clerk could be a [certified medical assistant] who answers patients’ telephone questions on the same day instead. If MD requests are PA’ed [more than] 80% of the time and the request is [less than] a specific amount (e.g., $5,000), then the PA should not be required. These PA requirements delay my cancer patients’ diagnostic studies and biopsies by 3-4 weeks.
3. The abolition of the observation vs. inpatient status dichotomy. I cannot predict who will tolerate the surgery and post-op pain well enough to be discharged within 48 hours vs. those who need a few extra days. Who can predict which neck abscesses respond to incision and drainage in two days vs. five days? Patients with minimal other comorbidities do better when they are discharged with a competent caregiver. They walk more at home, face less exposure to hospital antibiotic organisms, and pose less cost to hospitals.
