This legislation enacts the Consolidated Appropriations Act, 2026, providing funding for numerous federal departments and agencies for the fiscal year concluding on September 30, 2026. It is structured into several divisions, each addressing specific areas of government spending and policy. Division A allocates funds for the Department of Defense , covering military personnel, operation and maintenance, procurement of aircraft, missiles, and naval vessels, as well as research, development, testing, and evaluation. Significant amounts are directed towards the Defense Health Program, chemical agent destruction, drug interdiction, and the Counter-ISIS Train and Equip Fund. General provisions in this division address fund transfers, Buy American requirements, and reporting on special access programs. Division B funds the Departments of Labor, Health and Human Services, and Education . For Labor, it supports employment and training services, veterans' programs, and agencies like OSHA and the Bureau of Labor Statistics. Health and Human Services appropriations include substantial funding for primary health care, the Ryan White HIV/AIDS Program, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) for various research initiatives, and the Substance Abuse and Mental Health Services Administration (SAMHSA). This division also provides critical funding for the Centers for Medicare & Medicaid Services (CMS), including grants to states for Medicaid and payments to Medicare trust funds. The Administration for Children and Families (ACF) receives allocations for child support enforcement, low-income home energy assistance, refugee and entrant assistance, and the Child Care and Development Block Grant. The Department of Education's funding supports programs for disadvantaged students, special education, higher education, and student financial assistance, including Pell Grants. Division D focuses on the Department of Transportation and Housing and Urban Development . Transportation funding is allocated to the Federal Aviation Administration (FAA) for operations, facilities, and research, and to the Federal Highway Administration (FHWA) for federal-aid highways and infrastructure programs. Other agencies like the Federal Motor Carrier Safety Administration (FMCSA), National Highway Traffic Safety Administration (NHTSA), Federal Railroad Administration (FRA), and Maritime Administration (MARAD) also receive appropriations. For Housing and Urban Development (HUD), the bill provides funding for tenant-based rental assistance, public housing, homeless assistance grants, and housing for the elderly and persons with disabilities. It also includes allocations for community development, fair housing activities, and lead hazard reduction programs. General provisions across these departments address reporting requirements, limitations on fund use, and competitive grant processes. Divisions E and F contain various legislative extenders and technical corrections. Division E extends several federal programs, including the United States Grain Standards Act, the National Flood Insurance Program, and E-Verify, while also making technical adjustments. Division F, the Health Care Extenders , modifies and extends numerous provisions related to Medicaid and Medicare. Key Medicare extensions include increased inpatient hospital payments for low-volume hospitals, add-on payments for ambulance services, and telehealth flexibilities. It also addresses pharmacy benefit manager (PBM) accountability, Medicare coverage for multi-cancer early detection screening tests, and includes provisions for the World Trade Center Health Program and other public health initiatives.