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Yes, regarding this particular topic I am immediately surrounded by all of those external voices, even internal, telling me of how ridiculous it would be for the US to follow through and pull out of the USMCA. My response of course is noting that I probably wouldn’t have given the topic a second thought had the President of the United States not mentioned that this was a consideration regarding the upcoming July 2026 USMCA review.

On June 3, 2026, CMS issued an Interim Final Rule titled “Medicaid Program; Community Engagement Requirement for Certain Individuals” (Interim Final Rule) establishing federal parameters for state implementation of Medicaid community engagement (i.e., work reporting) requirements for certain populations. The Interim Final Rule implements provisions of the President’s One Big Beautiful Bill Act signed into law in July 2025 (OBBA).

The Inflation Reduction Act (IRA) continues to reshape the US drug‑pricing landscape as federal implementation accelerates and market responses evolve. In 2025, regulators advanced core IRA programs affecting Medicare negotiation, inflation rebates, and benefit redesign, while litigation, executive action, and agency rulemaking clarified, and in some cases expanded, the federal government’s role in pharmaceutical pricing and access.