The Health CARE Act of 2026 is a comprehensive healthcare reform bill that establishes a new federal health plan available through insurance exchanges starting in 2028 for uninsured individuals, expands Medicare's drug price negotiation program to cover 30 drugs by 2030 and 50 by 2032, and extends these negotiated prices to participating private insurance plans. The bill significantly increases price transparency requirements by mandating hospitals, clinical labs, imaging centers, ambulatory surgical centers, and health plans disclose detailed pricing information online by January 2027, with daily civil penalties up to $300 or more for non-compliance. It also strengthens patient protections by capping out-of-pocket costs for prescription drugs at $2,000 annually starting in 2028, limiting insulin cost-sharing to $35 per month, requiring step therapy exception reviews within 72 hours, and establishing mandatory electronic prior authorization systems for Medicare Advantage plans by 2029. The bill modifies Medicaid funding formulas to provide enhanced federal matching during economic downturns and eliminates "spread pricing" practices where pharmacy benefit managers overcharge states for drugs. Finally, it expands Medicare coverage to include hearing aids and audiology services starting in 2028, with $370 million appropriated through 2036 for implementation, while authorizing open-ended funding for enforcement across the Departments of Labor and Health and Human Services beginning in fiscal year 2027.