Genomic Answers for Children’s Health Act of 2026

This bill clarifies that the Medicaid program must cover whole genome sequencing and whole exome sequencing for children with certain medical needs. Specifically, these tests are to be covered as a first-tier option when ordered by a physician for individuals suspected of having a genetic disorder, rare disease, or a health condition of unknown origin, including congenital anomalies, developmental delays, or intellectual disabilities. The coverage includes the sequencing of the individual and, for their primary benefit, first-degree biological relatives, along with all analysis, interpretation, and data reporting. Furthermore, the bill mandates that payment for these sequencing services be made separately and not bundled with other medical assistance. To ensure effective implementation, the Secretary of Health and Human Services is directed to conduct outreach and education, convening various national organizations to identify challenges and best practices, particularly concerning prior authorization. Within two years, HHS must publish a report detailing payment amounts, the number of children receiving sequencing, and health outcomes. Concurrently, the Comptroller General will analyze feedback on implementation, assess barriers such as prior authorization and workforce challenges for genetic counselors, and provide recommendations to HHS. The provisions of this Act are scheduled to take effect beginning January 1, 2027.