Pharmaceutical Commerce continues its H1 Review/H2 Outlook series with Amy Niles, chief mission officer at the Patient Advocate Foundation, in the third and final installment of a three-part video interview revisiting her 2026 predictions . Niles notes the Medicare Part D out-of-pocket cap continues to ease costs for beneficiaries, even as the ceiling itself keeps rising. Niles says she is watching Medicaid “very, very closely” heading into the back half of the year and is encouraging patients, patient groups and provider groups to get more involved in policy advocacy. “Sharing stories and making sure we continue to advocate for patient-centric policy solutions is really important,” she notes. She is also concerned about rising ACA exchange premiums and the reduced coverage opportunities she expects beneficiaries to face there.