Consolidated Appropriations Act, 2026 - Detailed breakdown

Prohibits the National Security Agency from using funds to target a U.S. person under section 702 of FISA or to acquire their electronic communications from a service provider under section 501 of FISA.

Prohibits using funds to transfer certain Guantanamo Bay detainees to the U.S., construct facilities in the U.S. to house them, or close the U.S. Naval Station at Guantanamo Bay.

Authorizes the Secretary of Labor to employ law enforcement officers to provide protection for the Secretary, their family, and other senior officials under specific threat conditions.

Directs the Secretary to update regulations to ensure that non-compliance with the English language proficiency requirement for commercial drivers triggers an out-of-service order.

Prohibits funds from being used to reduce the total number of uniformed Amtrak Police officers below the staffing level of May 1, 2019.

Prohibits recipients of funds from disseminating personal information obtained by a State department of motor vehicles, except for legally permitted uses.

Authorizes the U.S. Marshals Service to provide security services for designated courthouses as part of a pilot program, with reimbursement from the Administrative Office of the U.S. Courts.

Prohibits the District of Columbia from using federal or local funds to legalize or reduce penalties associated with schedule I controlled substances.

Prohibits funding for UN peacekeeping missions unless the Secretary of State certifies that the UN has effective policies to prevent human trafficking and sexual exploitation by its personnel.

Makes foreign government officials and their immediate family members ineligible for entry into the U.S. if there is credible information of their involvement in significant corruption or gross human rights violations.

Allows funds to be used for enhancing civilian police effectiveness and accountability through training and technical assistance in human rights, rule of law, and anti-corruption.

The Secretary of State must withhold assistance from foreign security units credibly accused of sexual exploitation or abuse during UN peacekeeping operations until accountability measures are taken.

Prohibits the use of any funds in the Act to support or justify the use of torture or other cruel, inhuman, or degrading treatment by any US government official or contractor.

Prohibits most foreign aid to the central government of a country that refuses a US extradition request for an individual indicted for killing a law enforcement officer or a crime with a maximum penalty of life without parole.

Mandates that entities of the Department of Defense comply with the Buy American Act when expending funds and prohibits procurement of certain items not produced in the U.S., such as steel plate and ball bearings.

Requires certain components for the TAO Fleet Oiler, Frigate, T-ARC(X), and T-AGOS(X) ship programs to be manufactured in the United States.

Prohibits OSHA funds from being used to enforce standards on farms with 10 or fewer employees and no labor camp, or on small businesses with low injury rates, with certain exceptions.

Exempts certain disaster claims adjusters from overtime pay requirements under the Fair Labor Standards Act for two years following a major disaster.

Allows seafood industry employers to bring in approved H-2B workers anytime within a 120-day period from the start date without filing a new petition.

Sets the prevailing wage for H-2B workers as the greater of the actual wage paid to similar employees or the local prevailing wage, and requires acceptance of statistically sound private wage surveys.

Prohibits funds from being used to enforce certain H-2B program rules, including the 'three-fourths guarantee rule', and specifies the definition of 'temporary need'.

Prohibits using funds to cancel or renegotiate existing Essential Air Service (EAS) contracts unless requested by the EAS community, provided the carrier is in compliance with the contract.

Prohibits funds from being used to enforce electronic logging device requirements for commercial motor vehicles transporting livestock or insects.

Permits the use of local hiring preferences on federally assisted transportation projects only if the grant recipient certifies there is a local pool of unemployed workers and no project delays will result.

Establishes loan guarantee commitment limits for FHA's Mutual Mortgage ($400B), General/Special Risk ($35B), and Ginnie Mae's mortgage-backed securities ($550B) programs.

Prohibits the FHA, Ginnie Mae, or HUD from insuring or guaranteeing any mortgage that refinances a property seized through eminent domain by a state or local government.

Requires any entity receiving funds under this act to comply with the Buy American Act and prohibits funds to any entity convicted of violating it.

Prohibits any funds appropriated in this Act from being used by the Department of the Treasury or the Bureau of Engraving and Printing to redesign the $1 Federal Reserve note.

Directs the Secretary of the Treasury to issue a report on the authorities used to establish the Strategic Bitcoin Reserve and U.S. Digital Asset Stockpile and its impact on the Treasury Forfeiture Fund.

Prohibits funds from being used to finalize a safety standard for Recreational Off-Highway Vehicles until a National Academy of Sciences study is completed and delivered to Congress.

Prohibits the Federal Communications Commission from using funds to change its rules regarding single connection or primary line restrictions on universal service support payments.

Exempts the acquisition of commercial information technology from the restrictions of the Buy American Act to promote government access to commercial IT.

Prohibits the Securities and Exchange Commission from using funds to finalize, issue, or implement any rule requiring the disclosure of political contributions.

Prohibits federal government contracts with any foreign incorporated entity which is treated as an inverted domestic corporation, with a waiver for national security interests.

Authorizes the Millennium Challenge Corporation to extend compacts in Indonesia, Kosovo, Nepal, and Senegal for up to one additional year, subject to fund availability and congressional notification.

Requires bilateral agreements to exempt U.S. assistance from foreign taxation and withholds funds from countries that do not reimburse such taxes.

Prohibits funds from being used to finance the production of any commodity for export by a foreign country if it is in surplus on world markets and would cause substantial injury to U.S. producers.

Instructs U.S. executive directors at international financial institutions to oppose financing for projects that lack environmental and social safeguards or transparency, and to oppose any assistance to China.

Prohibits funds from being used for financial transactions with entities on the Cuba Restricted List or to support Cuban military or intelligence services.

Extends preferential trade treatment for certain products from designated sub-Saharan African countries through December 31, 2026.

Creates an exception under ERISA protecting responsible plan fiduciaries from liability if they reasonably believed a PBM was remitting all required rebates and took corrective action upon discovery.

Prohibits funds from being used to alter an interagency agreement or to close Civilian Conservation Centers and Job Corps Centers, except under specific criteria related to safety or performance.

Requires institutions receiving NIH funds to complete harassment investigations even if the subject leaves and gives NIH authority to decline award transfers due to unresolved misconduct concerns.

Considers children of deployed or deceased military personnel as eligible for Impact Aid payments for school year 2025–2026, even if they no longer meet standard eligibility criteria.

Sets the maximum Pell Grant award for which a student is eligible during the 2026–2027 award year at $6,335.

Requires the new federal student loan servicing environment to use multiple servicers, allocate accounts based on performance, and re-allocate accounts for non-compliance with consumer protection laws.

Directs the Secretary of Transportation to establish six new university transportation centers, prioritizing certain past applicants and using existing unobligated funds.

Increases the maximum tuition assistance grants for D.C. students, raising the annual public university grant to $15,000 and the private university grant to $3,750.

Prohibits the U.S. Consumer Product Safety Commission from using funds to promulgate, implement, administer, or enforce any regulation to ban gas stoves as a class of products.

Prohibits assistance to the Government of Mexico, except for counternarcotics efforts, until it delivers water owed to the United States under the 1944 treaty.

Prohibits biodiversity funds from supporting industrial logging, agriculture, or mining in primary tropical forests and directs the US to oppose such financing in international financial institutions.

Directs the Secretary of the Treasury to instruct U.S. representatives at multilateral development banks to advocate for removing prohibitions against financing nuclear energy projects.

Specifies that any reference to "this Act" within a division refers only to the provisions of that specific division, unless otherwise stated.

Gives explanatory statements printed in the Congressional Record the same legal effect as a joint explanatory statement of a conference committee for allocating funds.

Prohibits using funds to plan or implement the consolidation of budget or appropriations liaison offices of the DoD into a legislative affairs office.

Prohibits any appropriation in the Act from being used for publicity or propaganda purposes not authorized by Congress.

Allows the Department of Defense to employ non-U.S. citizens during the current fiscal year, with specific limitations on salary increases for foreign national employees.

Authorizes the Secretary of Defense, with OMB approval, to transfer up to $6,000,000,000 between appropriations for unforeseen, higher-priority military requirements, with prompt notification to Congress.

Rescinds specified amounts of previously appropriated funds from various Department of Defense accounts, including Shipbuilding and Conversion, Navy; Aircraft Procurement, Air Force; and multiple RDT&E accounts.

Prohibits converting activities performed by DoD civilian employees to contractor performance unless it results in cost savings of at least 10% or $10,000,000 and meets health benefit standards.

Prevents funds from being used to change the appropriations account structure, budget presentation, or fund apportionment process for the National Intelligence Program.

Prohibits contracts over $1 million with contractors who require employees to resolve sexual assault or harassment claims through arbitration as a condition of employment.

Requires the Department of Defense to continue applying the negotiated indirect cost rates from fiscal year 2024 and prohibits using funds to change them.

Prohibits using Job Corps funds to pay any individual's salary and bonuses at a rate exceeding Executive Level II.

Allows the transfer of up to 1% of discretionary funds between programs, with a maximum increase of 3% for any single program, subject to committee notification.

Authorizes the Secretary of Labor to sell or dispose of the property of the Treasure Island and Gary Job Corps Centers, with proceeds to be used for Job Corps programs in those areas.

Permanently rescinds $206,000,000 in unobligated funds from the Immigration and Nationality Act by September 30, 2026.

Prohibits using funds to pay an individual's salary through a grant or other extramural mechanism at a rate in excess of Executive Level II.

Allows the transfer of up to 1% of discretionary HHS funds between appropriations, with a 3% cap on increases, provided Congress is notified 15 days in advance.

Prohibits using funds to prevent a Senator or Member of the House from entering any facility housing unaccompanied alien children for oversight purposes, with 2-day advance coordination.

Allows the Department of Education to transfer up to 1% of discretionary funds between appropriations, with no single appropriation increased by more than 3%, after notifying Congress.

Rescinds $160,000,000 from the Department of Education Nonrecurring Expenses Fund and allows the transfer of up to $60,000,000 from the fund to the Innovation and Improvement account.

Prohibits the National Labor Relations Board from using funds to issue any new directive or regulation that would allow employees to vote electronically in collective bargaining elections.

Prohibits using appropriated funds for publicity or propaganda to influence legislation or regulations, including advocacy for tax increases or restrictions on legal consumer products like firearms.

Requires agencies to consult with and notify congressional appropriations committees 15 days in advance of reprogramming funds that create or eliminate programs, or move funds above specified thresholds.

Authorizes the Secretary of Transportation to transfer funds from specific programs to a central account for the costs of award, administration, or oversight of any DOT financial assistance program.

Restricts the number of political and Presidential appointees in the Federal Aviation Administration to nine and specifies the offices they must be assigned to.

Prohibits the use of any funds to plan, design, or implement the privatization or separation of the air traffic organization functions of the Federal Aviation Administration.

Allows the FAA Administrator to increase the basic pay for medical degree positions in the Office of Aerospace Medicine up to the annual compensation paid under section 102 of title 3, United States Code.

Directs the FAA Administrator to provide monthly spend plans and briefings to Congress on air traffic control modernization efforts during fiscal year 2026.

Requires the Secretary of Transportation to provide public notice and comment opportunity at least 15 days before waiving any Buy America requirement for Federal-aid highway projects.

Rescinds unobligated fiscal year 2023 balances for certain highway programs as of September 30, 2026, and reappropriates an equivalent amount to complete funding for awards from that year.

Prohibits funds from being used for overtime costs exceeding $35,000 for any individual employee, with a waiver available from the Amtrak President for safety and operational efficiency.

Permanently rescinds various unobligated balances from several railroad, maritime, and loan program accounts from previous fiscal years.

Authorizes the Department of Transportation to use applicable appropriations for the purchase, maintenance, operation, and deployment of unmanned aircraft systems.

Limits the number of political and Presidential appointees in the Department of Transportation to 125 and prohibits their temporary assignment outside the Department.

Requires the Secretary of Transportation to notify the House and Senate Committees on Appropriations at least 3 full business days before announcing discretionary grants, loans, or other agreements.

Rescinds all terminated and unobligated contract authority from the Housing Certificate Fund from fiscal year 1974 and prior years.

Prohibits public housing agencies from using funds for a salary for any official that exceeds the annual rate of basic pay for a position at level IV of the Executive Schedule.

Prohibits funds from being used for employee training that is not directly related to official duties, induces high stress, is offensive to personal values, or contains quasi-religious content.

Restricts agencies from reprogramming funds to create or eliminate programs, or to significantly alter funding for projects, without prior written approval from the House and Senate Committees on Appropriations.

Prohibits funds from being used for any project that uses eminent domain for economic development that primarily benefits private entities.

Requires any computer network maintained or established with these funds to block the viewing, downloading, and exchanging of pornography, with exceptions for law enforcement.

Prohibits the denial of timely access for any Inspector General to records, documents, or other materials available to their respective department or agency.

Amends project names, recipients, and descriptions for various community projects funded in previous appropriations acts for fiscal years 2022, 2023, and 2024.

Prohibits the Internal Revenue Service from using funds to target U.S. citizens for exercising First Amendment rights or to target groups for scrutiny based on ideological beliefs.

Authorizes the Secretary of the Treasury to use direct hire authority to recruit and appoint qualified applicants to process backlogged tax returns and information.

Prohibits the U.S. Mint from using any funds to construct or operate a museum without explicit approval from multiple congressional committees.

Prohibits the Treasury and IRS from issuing, revising, or finalizing any regulations related to the standard for determining if an organization operates for the promotion of social welfare (section 501(c)(4)).

Establishes procedures for reimbursable operating expenses at the Executive Residence, requiring advance payment for political events and setting collection timelines for all owed amounts.

Requires the Director of the Office of Management and Budget to provide a written statement on the budgetary impact of any Executive Order or Presidential memorandum issued or revoked during the fiscal year.

Allows for the transfer of up to 5 percent of any appropriation made available to the Judiciary to another Judiciary appropriation, with certain limitations and procedural requirements.

Requires any fiscal year 2027 request for U.S. Courthouse construction to meet specific design standards, reflect Judicial Conference priorities, and include a utilization study.

Prohibits funds from being used to increase space or services for any agency that does not pay the General Services Administration's assessed rate per square foot.

Requires the GSA Administrator to ensure the procurement area for leases matches the prospectus, or provide an explanatory statement to Congress if it differs.

Allows the Small Business Administration to transfer up to 5% of its appropriations between accounts, provided no single appropriation is increased by more than 10%, subject to reprogramming procedures.

Prohibits the use of funds to consolidate or close small rural and other small post offices.

Establishes limitations and approval requirements for the reprogramming of funds by agencies, preventing major changes to programs without prior approval from the Committees on Appropriations.

Prohibits the use of funds to deny an Inspector General timely access to any records, documents, or other materials available to their respective department or agency.

Permanently rescinds all unobligated balances from prior year appropriations provided for the Special Inspector General for Pandemic Recovery.

Prohibits using funds to pay the salary of any federal official who prevents or retaliates against another employee for communicating directly with Congress.

Prohibits federal funds for employee training that is not directly related to official duties, induces high stress, contains religious or "new age" content, or is offensive to personal values.

Prohibits using funds for publicity or propaganda purposes designed to support or defeat legislation pending before Congress, except in direct presentations to Congress.

Prohibits federal agencies from collecting personally identifiable information relating to an individual's internet use, with exceptions for law enforcement, security, and voluntary submissions.

Freezes the pay rates for the Vice President and senior political appointees in the Executive Schedule for calendar year 2026 at their December 31, 2025 levels.

Prohibits federal funds for contracts with entities that require employees to sign confidentiality agreements restricting them from lawfully reporting waste, fraud, or abuse.

Allows the District of Columbia to expend its own local funds during a federal government shutdown if a continuing resolution does not specifically appropriate D.C. funds.

Requires Federal and District government agencies receiving Federal funds in this Act to submit quarterly budget reports to the Committees on Appropriations.

Requires federal departments and agencies to provide a quarterly accounting of cumulative unobligated and unexpended balances to the Committees on Appropriations.

Authorizes security upgrades for diplomatic facilities, including soft targets, and prohibits using funds to move the U.S. embassy in Israel from Jerusalem.

Provides authority for the Department of State to transfer funds between certain accounts to respond to security situations, emergencies, and reorganizations, subject to limitations.

Prohibits funds for first-class travel, computer networks without filters for explicit content, tobacco promotion, and certain entertainment expenses.

Requires a multi-year strategy to improve foreign aid effectiveness, mandates collection of beneficiary feedback, and supports the ForeignAssistance.gov website.

Requires agencies to notify the Committees on Appropriations 15 days in advance of creating, suspending, or changing programs, or reprogramming significant funds.

Requires that if U.S. assistance to a foreign government is provided as a cash transfer or generates local currency, those funds must be kept in a separate account and not commingled with other funds.

Stipulates that U.S. assistance for democracy programs, including the implementing organizations and participants, shall not be subject to prior approval by the government of any foreign country.

Prohibits funds from supporting China's Belt and Road Initiative or its dual-use infrastructure projects. Also prohibits assistance to the Government of the People's Republic of China or the Chinese Communist Party.

Prohibits any funds appropriated by this Act or prior acts from being made available for assistance to the Taliban.

Withholds 50% of assistance to the central governments of El Salvador, Guatemala, and Honduras until the Secretary of State certifies they are combating corruption, protecting human rights, and strengthening rule of law.

Prohibits any funds appropriated by the Act from being made available for assistance to the central Government of the Russian Federation.

Prohibits funds from being used for any action or policy that recognizes the sovereignty of the Russian Federation over Crimea or other territory in Ukraine.

Prohibits assistance to the central government of any country that recognizes the independence of the Russian-occupied Georgian territories of Abkhazia and Tskhinvali Region/South Ossetia.

The Secretary of State must review a foreign government's UN voting record and its stance on Taiwan's participation in multilateral bodies when considering bilateral assistance.

Withholds 10% of contributions to UN organizations until they meet standards for financial transparency, whistleblower protection, combating anti-Israel bias, and vetting staff for terrorist affiliations.

Prohibits funding for US delegations to or contributions for any UN body chaired by a country determined to support international terrorism. A waiver is available for national interest.

Prohibits funding for the UN Human Rights Council until the Secretary of State certifies it is taking steps to remove Israel as a permanent agenda item. Also bans funds for the Commission of Inquiry on the Occupied Palestinian Territory.

Authorizes the transfer and use of aircraft procured with foreign operations funds for any program or region, subject to coordination by the Chief of Mission and reporting to Congress.

Mandates that funds intended to counter foreign propaganda and disinformation may only be used for activities targeting foreign state and non-state actors located outside of the United States.

Prohibits funds from being used to fly or display any flag over a U.S. Department of State facility other than a specified list, including the U.S. flag, POW/MIA flag, and flags of other sovereign nations.

Directs the U.S. Executive Director at the World Bank to continue the pause on disbursements and new financing commitments to Burma following the 2021 military coup.

Prohibits any funds appropriated for the Department of State or foreign operations from being used for a contribution, grant, or other payment to the United Nations Relief and Works Agency (UNRWA).

Amends the Continuing Appropriations Act, 2026 to extend government funding through February 13, 2026, to avoid a government shutdown.

Directs the Comptroller General to conduct a study on compensation and payment structures related to prescription drug prices within the Medicare Part D supply chain.

Directs the Secretary of Health and Human Services to establish an Abraham Accords Office within the FDA to strengthen regulatory oversight with Abraham Accords countries.

Directs the Secretary to establish a standard format for PBM reports within 18 months to ensure consistency and usability for group health plans.

Authorizes the Secretary to impose a penalty of $10,000 per day for failure to provide required information and up to $100,000 for knowingly providing false information.

Expands the definition of covered service providers to explicitly include pharmacy benefit management services, wellness design, compliance services, and other related administrative functions.

Directs the Secretary of Health and Human Services to issue guidance on how the FDA will determine if a generic drug is qualitatively and quantitatively the same as its brand-name counterpart.

Requires the Secretary of Defense to submit quarterly reports on the status of the electronic health record program, and the Comptroller General to perform quarterly performance reviews.

Removes time limitations on embryo cryopreservation and storage for seriously or severely ill/injured active duty service members under the assisted reproductive services policy.

Prohibits any funds made available by this Act from being used to support any activity conducted by or associated with the Wuhan Institute of Virology.

Prohibits funding for EcoHealth Alliance, Inc. work in China unless the Secretary of Defense grants a waiver for national security interests and justifies it to Congress.

Prohibits using Title X funds for abortions, requires non-directive pregnancy counseling, and bans use for promoting public support or opposition to legislation or candidates.

Requires applicants for Title X funds to certify that they encourage family participation in a minor's decision to seek family planning services.

Prohibits using funds for the Medicare Advantage program if an eligible entity is denied participation because it will not provide, pay for, or provide referrals for abortions.

Allows the Biomedical Advanced Research and Development Authority (BARDA) to enter into multi-year contracts for up to 10 years for research services or security countermeasures.

Prohibits using funds from the Federal Hospital Insurance Trust Fund or the Federal Supplemental Medical Insurance Trust Fund for ACA risk corridor payments.

Requires that any law referring to USPSTF breast cancer screening recommendations be administered as if it were referring to the recommendations issued before 2009, effective until January 1, 2028.

Prohibits CMS from applying distance requirements to certain critical access hospitals certified as of Jan 1, 2024, if they receive a noncompliance notice between Dec 1, 2024, and Jan 1, 2026.

Prohibits the use of funds for any abortion or for health benefits coverage that includes abortion, with exceptions for cases of rape, incest, or to save the life of the mother.

Prohibits the use of funds for the creation of human embryos for research purposes or for research in which human embryos are destroyed, discarded, or knowingly subjected to risk of injury or death.

Prohibits funds from being used to create or assign a unique health identifier for an individual until Congress enacts legislation specifically approving such a standard.

Prohibits using funds to purchase sterile needles or syringes for illegal drug injection, unless a health department determines the area is at risk for a significant hepatitis or HIV outbreak.

Prohibits Department of Transportation funds for fiscal year 2026 from being used to enforce a mask mandate in response to the COVID-19 virus.

Prohibits using funds to pay for abortions or for health plans that cover abortions under the Federal Employees Health Benefits Program, except where the mother's life is endangered or in cases of rape or incest.

Prohibits funds for any contract providing prescription drug coverage unless it also includes contraceptive coverage, with exceptions for religious plans and beliefs.

Prohibits the District of Columbia government from expending any funds for abortions, except where the mother's life is endangered or the pregnancy results from rape or incest.

Prohibits funds from being used for any organization that supports or participates in coercive abortion or involuntary sterilization programs. Also restricts funds for lobbying for or against abortion.

Mandates that voluntary family planning projects must not use quotas, bribes, or deny benefits, and must provide comprehensive information on health benefits and risks of contraceptive methods.

Prohibits using funds for the performance of abortions or involuntary sterilization as a method of family planning, or to coerce any person to undergo such procedures.

Allows the HIV/AIDS Working Capital Fund to also be used for pharmaceuticals and products for child survival, malaria, tuberculosis, and emerging infectious diseases.

Allocates funds for the UNFPA but prohibits their use for programs in China, requires segregation of funds, and bans their use for abortions. Funds are withheld dollar-for-dollar for any amount UNFPA budgets for China.

Explicitly prohibits any funds made available by this Act from being provided to the Wuhan Institute of Virology in the People's Republic of China.

Requires states to implement a streamlined process for enrolling eligible out-of-state healthcare providers to serve children under Medicaid and CHIP, reducing administrative barriers.

Eliminates the under-65 age limit for Medicaid eligibility for certain working adults with disabilities, allowing them to maintain coverage while employed.

Mandates that states conduct and submit studies every five years on the costs of maternity, labor, and delivery services. HHS will compile and report on the results.

Extends Tennessee's specific Disproportionate Share Hospital (DSH) allotment through fiscal year 2027 and delays nationwide DSH allotment reductions until fiscal year 2028.

Amends the calculation of hospital-specific limits on Medicaid Disproportionate Share Hospital (DSH) payments to include costs for individuals dually eligible for Medicare and Medicaid.

Extends increased Medicare inpatient payment adjustments for certain low-volume hospitals through fiscal year 2028.

Extends the Medicare-Dependent Hospital (MDH) program, which provides enhanced payments to certain small rural hospitals, through December 31, 2026.

Extends temporary add-on payments for ground ambulance services under Medicare through December 31, 2027.

Extends incentive payments for healthcare providers participating in eligible alternative payment models (APMs) under Medicare through payment year 2028.

Extends funding through fiscal year 2027 for the consensus-based entity that endorses and maintains a portfolio of quality and efficiency measures for Medicare.

Extends funding to support surveys of hospice programs to ensure compliance with Medicare requirements through December 31, 2026.

Extends the 1.0 floor on the work geographic index under the Medicare physician fee schedule through December 31, 2026, preventing payment reductions in certain areas.

Extends numerous Medicare telehealth flexibilities through December 31, 2027, including removing geographic restrictions, expanding originating sites, and allowing audio-only services.

Extends the Acute Hospital Care at Home initiative, allowing certain hospitals to provide inpatient-level care at home, through September 30, 2030, and mandates a new study on its impact.

Permits cardiac and pulmonary rehabilitation services to be provided in a patient's home using real-time audio and video technology from early 2026 through the end of 2027.

Requires Medicare to identify and review claims for durable medical equipment and prosthetics that show aberrant billing patterns, particularly when ordered by a new physician for a patient, starting in 2029.

Directs the Secretary of HHS to issue guidance on best practices for providing telehealth services to individuals with limited English proficiency, including the use of interpreters and multi-language materials.

Allows entities offering diabetes prevention services exclusively through distance learning or online methods to participate in the Medicare Diabetes Prevention Program (MDPP) from 2026 through 2029.

Directs the Secretary of HHS to educate Medicare practitioners on screening for medication-induced movement disorders in at-risk patients, including best practices for using telehealth for such screenings.

Requires the Comptroller General to assess and report on the capabilities, limitations, and policy options for wearable medical devices used in clinical decision-making, including the role of AI.

Extends the temporary inclusion of authorized oral antiviral drugs as covered Medicare Part D drugs through December 31, 2026.

Extends the adjustment to the calculation of the hospice cap amount under Medicare for two additional years, through 2035.

Modifies cost-sharing for low-income individuals under Medicare Part D, eliminating copayments for generic drugs and indexing copayments for other drugs to inflation starting in 2028.

Mandates that Medicare Advantage plans maintain accurate and regularly updated provider directories, and protects enrollees from higher costs if they use an out-of-network provider listed in the directory.

Authorizes Medicare to cover multi-cancer early detection screening tests for eligible beneficiaries starting January 1, 2029, and establishes payment rules and coverage limitations.

Expands Medicare coverage to include certain external infusion pumps and associated home infusion drugs that require professional administration, treating them as durable medical equipment.

Requires Medicare Prescription Drug Plan sponsors to allow any pharmacy that meets standard contract terms and conditions to participate in their network, effective January 1, 2029.

Requires the Secretary of HHS to publish reports every two years on trends in costs, payments, and network participation for essential retail pharmacies in Medicare, starting in 2028.

Creates a process for pharmacies to report alleged violations of reasonable and relevant contract terms by Medicare drug plan sponsors and protects them from retaliation.

Mandates that Pharmacy Benefit Managers (PBMs) must reimburse Medicare drug plan sponsors for any penalties incurred due to the PBM's violation of reasonable and relevant contract terms.

Imposes new requirements on Pharmacy Benefit Managers (PBMs) in Medicare, including limiting their income to bona fide service fees and mandating detailed annual transparency reports on drug costs and rebates.

Prohibits Medicare payment to off-campus outpatient departments unless they obtain a separate National Provider Identifier and attest to meeting federal requirements, effective January 1, 2028.

Delays the full implementation of payment reductions for Medicare clinical laboratory tests and revises the data collection and reporting periods for private sector payment rates.

Adjusts the Medicare payment reduction (sequestration) schedule, setting it at 2.0% for a fiscal year and establishing a split reduction for fiscal year 2033 (2.0% for 5 months, 0% for 7 months).

Extends funding for Family-to-Family Health Information Centers through December 31, 2026.

Extends various national health security and preparedness programs, including the Public Health Emergency Fund and the Strategic National Stockpile, through December 31, 2026.

Modifies the funding formula for the World Trade Center Health Program for fiscal years 2026 through 2040 and requires a report on the program's long-term budgetary needs.

Requires Maternal Mortality Review Committees to include obstetricians and gynecologists and improve death record reporting. Mandates the CDC to disseminate best practices annually.

Updates OPTN requirements to encourage electronic health record integration, consider a public data dashboard, and authorizes the Secretary to collect registration fees from members for three years.

Prohibits consideration of the organ recipient's income when reimbursing living donors for expenses and removes the expectation that recipients will pay for these costs.

Reauthorizes research programs related to preterm labor and delivery through 2030 and mandates the establishment of an interagency working group and a National Academies study on premature births.

Extends programs for disseminating best practices and promoting mental health among the health professional workforce, and reauthorizes an education and awareness initiative through 2030.

Expands requirements for molecularly targeted pediatric cancer investigations to include studies of a drug in combination with other active ingredients relevant to pediatric cancer.

Strengthens the FDA's ability to take enforcement action against drug manufacturers who fail to complete required pediatric studies, provided a lack of due diligence is shown.

Amends reporting requirements for the FDA to include evaluations of compliance with pediatric study deferral deadlines and a list of penalties for non-compliance.

Extends the FDA's authority to award priority review vouchers for rare pediatric disease drugs until September 30, 2029, and mandates a GAO study on the program's effectiveness.

Narrows the 7-year market exclusivity for orphan drugs to apply only to the specific approved use or indication, rather than the entire rare disease or condition.

Requires PBMs to provide detailed semi-annual reports to group health plans on drug costs, rebates, and fees, and establishes civil monetary penalties for non-compliance.

Requires group health plans and insurers to ensure their pharmacy benefit managers (PBMs) provide detailed semi-annual reports on drug costs, compensation, rebates, and spending.

Mandates that PBMs provide semi-annual (or quarterly, upon request) reports to group health plans, detailing drug costs, compensation, rebates, fees, and other financial information.

Ensures that all information reported by PBMs is handled in a manner consistent with HIPAA and other federal privacy regulations to protect patient data.

Requires group health plans to provide participants, upon request, a summary document of PBM services and specific information about drug cost differences.

Requires Pharmacy Benefit Managers (PBMs) to provide semi-annual, detailed reports to group health plans on drug costs, rebates, compensation, and spending to increase transparency.

Requires group health plans to provide participants, upon request, a summary of PBM reports and specific information about the difference in drug costs paid by the plan versus the pharmacy.

Amends ERISA to require that Pharmacy Benefit Managers remit 100% of all rebates, fees, and other remuneration received from drug companies back to the group health plan or issuer.

Requires the FDA, upon request, to inform generic drug applicants if their proposed drug's inactive ingredients are the same as the brand-name version and to identify any differences.

Prohibits the use of funds to change weight restrictions or prior permission rules at Teterboro airport in Teterboro, New Jersey.

Allows states and territories to use earmarked highway funds that are over 10 years old for any eligible highway or transportation project within their boundaries, with certain conditions.

Makes the Union Station Redevelopment Corporation eligible to receive grants under the Federal-State Partnership for Intercity Passenger Rail program for fiscal year 2026.

Prohibits funds from being used to impede or hinder project approval for any project seeking a Federal contribution of greater than 40 percent of project costs.

Makes unobligated balances from prior programs available for transportation assistance for the 2028 Olympics and Paralympics and the 2026 FIFA World Cup.

Exempts the Long Bridge Project, which expands rail, bike, and pedestrian access over the Potomac River, from certain District of Columbia railroad installation laws.

Requires that individuals or forces receiving assistance to counter ISIS are appropriately vetted for associations with terrorist groups or the Government of Iran.

Prohibits funds from being used for the construction of any naval vessel in foreign shipyards or for major components of vessels in foreign facilities.

Prohibits initiating multiyear contracts over $500,000,000 unless specified in this Act and requires 30-day congressional notification for contracts with liabilities over $20,000,000.

Prohibits the use of funds to retire, prepare to retire, or place in storage any C–40 aircraft, unless an individual aircraft is deemed non-mission capable due to a major mishap.

Prohibits using research and development funds to procure end-items for operational use, inventory, or training, with exceptions for development, prototyping, and testing activities.

Prohibits the obligation or expenditure of funds for repairs or maintenance to military family housing units.

Prohibits transferring certain types of armor-piercing and special-purpose ammunition to any non-governmental entity, except for demilitarization services.

Prohibits the use of funds for research, development, test, evaluation, procurement, or deployment of nuclear-armed interceptors for a missile defense system.

Prohibits the obligation or expenditure of funds for the purpose of decommissioning more than one Littoral Combat Ship.

Prohibits any funds made available by the Act from being used to provide arms, training, or other assistance to the Azov Battalion.

Prohibits the Department of Defense from entering into contracts or other agreements with the Russian arms exporter Rosoboronexport or its subsidiaries, with a national security waiver available.

Prohibits funds from being used to establish permanent military bases in Iraq or to exercise U.S. control over any oil resources of Iraq or Syria.

Prohibits the obligation of any funds to integrate an alternative engine on any F-35 aircraft.

Allows funds for the Defense Innovation Unit (DIU) Fielding to be used for agile research, development, procurement, and operations, pending submission of a detailed execution plan to Congress.

Prohibits the use of funds to divest or prepare to divest more than eight U–2 aircraft.

Mandates that funds for the Next Generation Fighter, UH-60 Blackhawk, and E-7 Wedgetail programs be used only for their appropriated purposes and prohibits pausing, canceling, or terminating them.

Prohibits the use of funds to close the Rock Island Arsenal Museum, Fort Sill National Historic Landmark and Museum, U.S. Army Transportation Museum, or General George Patton Museum of Leadership.

Prohibits the use of funds to pause, cancel, or terminate the Next-Generation Overhead Persistent Infrared Geosynchronous Earth Orbit and Polar programs.

Requires the Secretary of Defense to brief and provide a detailed execution plan to congressional committees before obligating funds for the solid rocket motor industrial base.

Prohibits any funds made available in this Act from being used in contravention of the American Security Drone Act of 2023.

Requires that the Committees on Appropriations be notified at least 15 days before any vote on a new or expanded United Nations peacekeeping mission, including details on cost, duration, and objectives.

Prohibits providing lethal military equipment or bilateral assistance to any foreign government that supports international terrorism or grants sanctuary to terrorists.

Mandates that combat casualty care training and equipment be offered as a component of any lethal assistance package funded by this Act for countries in conflict.

Prohibits the use of appropriated funds to support any military training or operations that involve child soldiers.

Prohibits military assistance, export licenses, or sales of cluster munitions unless they have a low failure rate and are not used where civilians are known to be present.

Authorizes the Secretary of the Air Force to convey excess relocatable military housing units from several Air Force Bases to Indian tribes in specified states at no cost.

Allows outlying areas to submit a single application for a consolidated grant for workforce activities and use the funds for any authorized program under WIOA subtitle B.

Prohibits obligating or expending funds for goods or services produced by forced or indentured child labor, as identified by the Department of Labor.

Makes an additional $15,000,000 available for each month the number of unaccompanied children referred to HHS exceeds 16,000, with pro-rated amounts for increments.

Restricts federally funded protection and advocacy systems from pursuing legal action to close state-operated intermediate care facilities without providing public notice to affected individuals.

Restricts funding for housing unaccompanied alien children in non-State-licensed facilities and establishes standards, monitoring, and waiver processes for such facilities when used temporarily.

Requires the Secretary to submit monthly public reports on children separated from their parents by DHS and transferred to the Office of Refugee Resettlement, including cause and location of separation.

Sets the AmeriCorps program minimum share requirement at 24% for the first three years of funding, after which existing regulations apply, subject to partial waiver.

Allows the CEO of the Corporation for National and Community Service to award a pro-rated educational award to participants who must exit a position early due to circumstances beyond their control.

Prohibits the Social Security Administration from using funds to pay employee compensation for administering benefit payments under a totalization agreement with Mexico.

Provides $107 million to fund demonstration projects in up to 25 communities, with a priority for rural areas, to develop comprehensive approaches to reduce youth homelessness.

Allocates $7.5 million for competitive grants to provide no-cost legal assistance to low-income tenants at risk of or subject to eviction.

Creates a $50 million competitive grant program for state and local governments to identify and remove barriers to affordable housing production and preservation.

Allows public housing agencies with low-scoring properties to use operating reserve funds for capital improvement activities to address poor physical conditions.

Requires that 50% of recaptured funds from certain homeless assistance projects be rescinded, with the remainder used by state or local housing agencies. Allows up to 15% for refinancing incentives.

Authorizes HUD to transfer project-based assistance, debt, and use restrictions from obsolete or nonviable multifamily projects to other projects, subject to conditions protecting tenants and unit counts.

Prohibits Section 8 housing assistance for individuals who are under 24, enrolled in higher education, and do not meet specific exceptions such as being a veteran, parent, or person with a disability.

Requires HUD to take enforcement action against multifamily projects with failing physical inspection scores, including issuing a Notice of Default and imposing penalties like contract abatement or transfer.

Authorizes the HUD Secretary to forgive or restructure certain loans for smaller, well-performing affordable housing properties to ensure their long-term stability.

Designates the assistance made available for tenant-based rental assistance for foster youth as 'The Melania Trump Foster Youth to Independence Initiative'.

Permits a woman to breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present.

Authorizes the Secretary of State to withhold foreign assistance funds from the central government of any country not taking appropriate steps to comply with the Hague Abduction Convention.

Extends provisions that establish categories of aliens from the former Soviet Union, Estonia, Latvia, Lithuania, and Indochina who are eligible for refugee status for admission to the United States.

Extends the authority for the National Flood Insurance Program to issue new contracts and borrow funds through September 30, 2026.

Requires states, starting Jan 1, 2030, to treat relocating active-duty military members and their families as residents for Medicaid eligibility and preserve their place on home and community-based services waiting lists.

Extends funding through December 31, 2027, for programs that assist low-income seniors and individuals with disabilities in accessing benefits, including SHIPs and Area Agencies on Aging.

Extends the authorization and funding for the Sexual Risk Avoidance Education program through December 31, 2026.

Extends the authorization and funding for the Personal Responsibility Education Program through December 31, 2026.

Extends the Temporary Assistance for Needy Families (TANF) program through December 31, 2026.

Expands the definition of "family caregiver" to include any unpaid individual, not just adults, and extends the authorization for the Lifespan Respite Care program through fiscal year 2030.

Prohibits using funds to pay the salary of a person filling a position formerly held by an employee who left for the Armed Forces and has applied for restoration to their position.

Prohibits the use of funds made available in this title to advocate or promote gun control.

Prohibits using funds to limit the ability of private aircraft owners to block their aircraft's identifying information from public real-time flight tracking displays for noncommercial flights.

Prohibits direct assistance or reparations to the governments of Cuba, North Korea, and Iran.

Prohibits financing direct assistance to the government of any country whose duly elected head of government is deposed by a military coup or decree.

Prohibits funding for a Palestinian state unless it demonstrates commitment to peaceful co-existence with Israel and takes measures to counter terrorism. A waiver is available for national security.

Prohibits any appropriated funds from being used to provide any form of assistance to the Palestinian Broadcasting Corporation.

Prohibits funds from being provided to the Palestinian Authority, though the President may waive this for national security interests.

Prohibits funding for Hamas, the Palestine Liberation Organization, or any government of which Hamas is a member or exercises undue influence.

Prohibits aid to the Palestinian Authority if Palestinians gain full UN membership or initiate an ICC investigation against Israeli nationals, with a national security waiver available.

Prohibits assistance for the central governments of South Sudan and Sudan unless it is to support the implementation of a viable peace agreement.

Directs the U.S. to vote against loans or grants to Zimbabwe and prohibits direct assistance (except for health/education) until the rule of law is restored.