Aging in America News

| Why 2026 Could Be a Nourishing Policy Year
| Bob Blancato and Laura Borth

| As 2026 gets under way, there are strong signals that this could be one of the most impactful years for nutrition policy, especially for older adults. Nutrition has long lived on the sidelines of healthcare and aging policy. This year, it’s moving to the center of the conversation. 

The spark came with the release of the 2025-2030 Dietary Guidelines for Americans (DGAs). The new guidelines emphasize more protein, fewer highly processed foods, and the elevation of whole foods. The DGAs generated plenty of debate, but they created something more important: a window for policy change. 

For older adults, the stakes are high. Almost all live with at least one chronic condition, yet nutrition care is seldom integrated into treatment plans. And while the DGAs acknowledge older adults, they stop short of addressing aging-specific needs like muscle loss or malnutrition. They also promise reductions in chronic disease without explaining how, though they did highlight the critical connection between nutrition and health.

Crucially, the DGAs are not just symbolic. They are the nutrition blueprint for major federal programs, including congregate and home-delivered meals and their nutrition education under the Older Americans Act. Translating those guidelines into real-world health benefits for older adults will require different procurement and preparation. Without federal investment, the guidelines risk becoming aspirational rather than transformative. Apart from the DGAs, many policy developments that began in 2025 are poised to move forward this year, significantly affecting how older adults access and benefit from nutrition services and care.

Will Congress Treat Nutrition as Healthcare?

A series of legislative efforts that began in 2025 are carrying into 2026 with real momentum. If successful, these bills could reshape how older adults access nutrition care. 

At the end of 2025, a bipartisan bill (HR 6199) was introduced to expand Medicare coverage of Medical Nutrition Therapy (MNT), personalized, disease-specific nutrition counseling by a Registered Dietitian Nutritionist. Right now, Medicare only covers MNT for diabetes and kidney disease. This bill would expand coverage to cancer, heart disease, malnutrition, obesity and other more. A recent analysis found that if beneficiaries had access to these services and used them, it could save an estimated $33 million a year through fewer hospital and outpatient visits.  If the bill passes, older adults with serious chronic illnesses would finally have access to nutrition care that treats food as part of treatment, not just lifestyle. There are early signs that this could be folded into a broader healthcare package expected later this year, with the DGAs helping to underpin its importance.

The bipartisan Treat and Reduce Obesity Act (TROA, HR 4231 / S.1973) is another bill with renewed momentum. Obesity is a major intergenerational health issue, affecting mobility, chronic disease, and quality of life. More than two in five adults and over a quarter of older adults have obesity, while childhood obesity has doubled since 1990. In 2025, the Administration expanded coverage of GLP-1 medications, marking a major policy shift. TROA would complement this change by expanding Medicare coverage to include obesity including behavioral counseling. The Defeat Malnutrition Today advocacy team continues to stress that any obesity care plan must include nutrition care.  

The Food is Medicine movement, which integrates food-based interventions such as medically tailored meals and groceries into treating medical conditions, gained traction in 2025. Key developments include the Medically Tailored Meal Act of 2025 (HR 5439) and CMS demonstration projects MAHA ELEVATE model and BALANCE model. These pilots test how food and nutrition interventions can reduce hospitalizations and healthcare spending for high-risk individuals. Since older adults experience both high chronic disease burden and high food insecurity risk, 2026 could be the year Food Is Medicine moves toward scalable payment models. For decades, Medicare paid for medications but not the nutrition support that prevents needing them.

Nutrition isn’t just happening in hospitals, it’s happening in communities, and the Older Americans Act (OAA) is the backbone of that infrastructure. The OAA nutrition programs are the largest national nutrition services for older adults, providing congregate and home-delivered meals, nutrition education, and socialization opportunities. Every year, they serve over 240 million meals to 2.5 million older adults. For many, it’s the only hot meal of the day and the only social interaction. Here as well, a bipartisan OAA Reauthorization bill (S.2120) was introduced to extend and increase funding for four years. Early signals from the House point to willingness to take up the bill. The DGAs add urgency. Because OAA meals must align with the DGAs, updated standards could increase costs. Reauthorization and appropriations will determine whether providers can meet those standards without cutting meals or incurring wait lists.

Health Systems Are Catching Up 

The Age-Friendly Health Systems concept, built around “4Ms” (What Matters, Medication, Mentation, and Mobility), is gaining traction across hospitals and clinics, emphasizing tailored care for older adults. Nutrition is a core component of this model, and its integration into broader care practice could accelerate in 2026.

CMS is expected to issue decisions on social care codes, including those for nutrition screening and counseling. If implemented, this could transform how nutrition services are reimbursed across care settings, supporting better referrals from hospitals to community programs and reduce a care cliff that older adults face after hospital discharge. 

Meanwhile, Medicare Advantage (MA) plans continue to experiment with non-medical supplemental benefits like groceries and meals for beneficiaries with chronic illness, suggesting a renewed focus on nutrition supports. 

The year also began with $50 billion in funds being released for the Rural Health Transformation Program funding. Nutrition services, including nutrition-focused continuing medical education (CME) for clinicians, are expected benefit rural older adults who face barriers to food and medical access.

Malnutrition Moves into the Spotlight

Malnutrition is gaining separate and overdue attention in 2026. A widely read Washington Post article spotlighted rising malnutrition rates among adults 85 and older, a group often overlooked in nutrition research and policy. This coverage coincided with a CMS Request for Information (RFI) on adding the Malnutrition Composite Score (MCS) to outpatient quality measures, major expansion beyond hospitals. If adopted, it would increase malnutrition screening, assessment, diagnosis, and treatment across care settings. Defeat Malnutrition Today, which helped secure adoption of the MCS in hospitals in 2022, submitted comments in support of this expansion.  

What to watch in 2026

Several policy decisions still ahead could reshape access to nutrition supports for older adults, including: implementation of updated SNAP work requirements, decisions on the future of MAHA, rulemaking on social care codes, and potential healthcare and OAA legislation. Meanwhile, cultural discussions around beef tallow, ultra processed foods, protein enhancers, and personalized Nutrition will shift how Americans think about food and health. If Congress and the Administration capitalize on the current momentum, 2026 could truly be a nourishing policy year, one that treats nutrition not as a lifestyle choice, but as core infrastructure for healthy aging. 

Robert Blancato is National Coordinator and Laura Borth is Policy Director of the Defeat Malnutrition Today coalition.

---