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After several years of difficulties, the health insurance industry may enter an adjustment period in 2026. Experts expect profit margins to recover, but the ACA market faces risks of subsidy expiration and a death spiral, Medicare Advantage plans may become a highlight, M&A activity accelerates, and AI adoption speeds up.

In 2026, healthcare systems will continue to expand AI applications to address financial pressures, but the absence of federal regulation and fragmented state-level legislation create a complex environment. AI companies' share of funding is expected to reach new highs, with accelerated M&A integration, while facing competition from EHR giants.

In 2026, medical institutions are experiencing a relatively stable start against the backdrop of an improved labor market, rebounding patient volumes, and stabilizing profit margins, but experts point out that the real challenge lies in execution—how to complete cost control, workforce planning, and investment positioning before reimbursement pressures intensify.

Whoop received a warning letter this summer for adding a blood pressure feature to its health band without FDA authorization. The company argued that the feature falls within the health category, but the FDA considers blood pressure related to medical diagnosis. Experts predict the FDA will not back down and note that other companies such as Aktiia and Apple have obtained authorization, which may make Whoop's position more difficult. The article also explores the FDA's regulatory framework for health features, industry impact, and how companies should mitigate risks.

At the HLTH 2025 conference, experts noted that healthcare organizations are accelerating the adoption of artificial intelligence, but the methods for measuring the return on investment (ROI) of AI remain unclear. Facing financial pressures and coverage reductions, hospitals need to explore multi-dimensional evaluation approaches.

Artificial intelligence has the potential to ease the burden on clinicians, but resource-poor safety-net healthcare institutions face multiple challenges in implementing AI, including technology, funding, and talent, which may widen healthcare disparities.

States across the U.S. are sharply divided in access to COVID-19 vaccines, with some restricting vaccinations while others strive to secure supply, leaving patients and doctors facing confusion and uncertainty.

Over the past year, medical device companies such as GE HealthCare and Philips have launched or announced plans to build "foundation models" for imaging modalities like MRI, and the FDA is also exploring ways to flag such products when updating its AI device database. However, experts note that the definition of foundation models remains unclear, and it is difficult to determine whether existing tools truly help radiologists and patients. Stanford scholars believe that although foundation models hold potential in rare disease detection and accelerating AI development, their clear advantages have not yet been observed in the market.