Bone Health and Osteoporosis Foundation 2026 Policy Agenda
Osteoporosis is a major public health threat for an estimated 54 million Americans. One in two women and up to one in four men over the age of 50 will suffer a fracture due to osteoporosis. The annual cost of these fractures is staggering: over $57 billion and without reforms will rise to over $95 billion in 2040 as our population ages. BHOF is aggressively working to advance public policies that reduce the toll that osteoporosis takes on our nation and improve bone health through the lifetime.
The 2026 Policy Agenda targets a number of important reforms to federal government and state government policy to improve post-fracture care, better prescription drug access and affordability, educate health professionals and the public, promote lifesaving research and protect non-profits like BHOF from political targeting.
Improving Post Fracture Care/Reducing Preventable Second Fractures
Over 1.8 million Americans on Medicare suffered over 2 million fractures caused by osteoporosis in just one year. Taxpayer investments in research have given us excellent ways to detect and treat osteoporosis, yet most patients who experience a fracture are never treated for the underlying disease. Many then suffer preventable additional fractures. Post-fracture care models known as Fracture Liaison Service (FLS) have been proven to reduce additional fractures by ensuring that patients receive a coordinated comprehensive fracture risk assessment, appropriate osteoporosis treatment and fall prevention interventions.
Medicare Coding Update and Guidance to Providers
BHOF is continuing its effort to improve patient access to model post-fracture care by working with Congress, the Center for Medicare and Medicaid Services (CMS) and medical professional groups to establish a clear payment mechanism and coding guidance to providers for this cost-effective care. This common-sense change would save lives, reduce the use of opioids, cut nursing home admissions and reduce the soaring health costs associated with osteoporotic fractures.
Raising Awareness and Expanding Health Professional and Consumer Education
In order to reduce the cost and care burden of osteoporosis, we need to better educate patients and health professionals about bone health best practices. There is a substantial gap in awareness about osteoporosis. A 2023 global survey from the International Osteoporosis Foundation found that nearly one-third of adults have never discussed bone health with a healthcare provider, and among those who have, only a small percentage recall discussing key risk factors. These awareness gaps translate into missed care opportunities: a 2025 analysis published in Osteoporosis International estimates that approximately 69% of individuals with osteoporosis remain undiagnosed. Even after a fracture, up to 45% of patients receive no treatment and as many as 83% receive no appropriate follow-up care. This data underscores the urgent need for improved education, earlier screening, and stronger systems of post-fracture care to prevent avoidable fractures and long-term disability.
CDC Chronic Disease Grant Funding
BHOF was one of six national organizations to be chosen by CDC through a 2024 nationwide competitive application process to advance education and awareness of chronic diseases. We are in the second year of this landmark three-year effort to educate health professionals and the public about osteoporosis. As a part of our efforts to combat the burden of chronic disease, BHOF is working with allies in Congress to protect the Chronic Disease Education and Awareness grants provided by the CDC that make this effort possible. In 2025, Congress responded to our work by continuing funding. We are working in 2026 to assure that our cost-effective educational campaign can be completed.
Congressional Resolution: Osteoporosis Awareness and Prevention Month
This year, BHOF is working with Senator Susan Collins (R-ME) and other Congressional champions to have the United States Congress pass legislation supporting May 2026 as national Osteoporosis Awareness and Prevention Month. Such a resolution provides a great opportunity to educate your Members of Congress about the importance of bone health and the major impact osteoporosis has on our lives and on health care costs. By joining on as cosponsors of the resolution, Members of Congress can express their support for greater education and awareness and demonstrate the importance Congress places on improving bone health and bone health policy.
State Resolutions/Proclamations
In 2025, BHOF was successful in encouraging 25 states to either introduce legislation or issue Governor proclamations declaring May as Osteoporosis Awareness and Prevention month to encourage greater awareness and action to reduce the toll of osteoporosis and promote good bone health through the lifetime. This year, BHOF is again working to get states to take this important step to raise awareness and advance action.
Protecting and Improving Access to Affordable Care
Safe Step Act
Step therapy or “fail first” is a practice by insurance companies that forces patients onto alternative treatments before advancing to the health professional’s prescribed medication. This can be especially hazardous for patients with chronic conditions who are at risk of disease progression. The bipartisan Safe Step Act (S. 2903/ H.R. 5509) would require health plans to allow patients to skip certain insurer-mandated steps, outline how patients may ask for exemptions, and quickly respond to patients’ requests, saving them time and safeguarding them from potentially dangerous side effects.
State Briefings and State Bone Health Policy Blueprint
There are many steps that state policymakers can take to improve bone health and osteoporosis policy. BHOF is actively engaging state leaders to raise awareness and spur reforms that can improve care, save lives and reduce costs.
BHOF has held briefing for state policymakers in New Jersey, Connecticut and Pennsylvania on the impact of osteoporosis and menopause in their states and actions steps they can take to address them. Following our New Jersey briefing with the office of Assemblywoman Heather Simmons, the Governor signed her bill, A5278, which requires health insurers to cover diagnosis and treatment of osteoporosis and other conditions tied to menopause.
BHOF collaborated with Women in Government to present Strong Bones – Healthy States: Reducing Medicaid Costs Through Fracture Prevention about how strengthening bone health screening and prioritizing fracture prevention can reduce hospitalizations and long-term care needs, lower state Medicaid costs and deliver better health outcomes.
BHOF has developed a set of policy options that states can implement to improve bone health and reduce the toll of osteoporosis. These include reforms to Medicaid and Medicaid managed care plans to incentive better screening and fracture care, supporting health professional education and raising public awareness.
Inflation Reduction Act
The Inflation Reduction Act contains provisions aiming to lower drug prices for those on Medicare. BHOF applauds its goal of capping out of pocket Medicare Pard D costs, lowering the cost of insulin and making vaccines for adults cost-free for seniors and others. Too many people with osteoporosis and other chronic conditions struggle to pay for the medications they need. At the same time, it is important to make sure that the implementation of these important new provisions doesn’t have unintended consequences. For example, we need to keep strong incentives for the continued development of innovative treatments. It is also very important for CMS to hear directly from patients and respond to patient input as they continue to implement these provisions.
Protecting Women’s Health Research and Defending Non-Profit Organizations
We have made substantial advances in expanding research into osteoporosis and women’s mid-life health, research that can improve care and save lives.
Medical Research
Proposals have been put forward in Washington to substantially reduce funding for medical research. BHOF is working with other organizations and allies in Congress to protect crucial investments in medical research. We are pleased to report that legislation signed into law earlier this year rejected these proposed cuts and continued strong support for research to improve the care of those with osteoporosis. BHOF continues to advocate for protecting these important investments.
Charities
Proposals have also been put forward that would seriously undermine the work that BHOF and other non-profit charities can do by eliminating Americans’ ability to receive tax deductions for donations to health-related charities. BHOF has written to key Congressional Committees to educate them about the important patient assistance that could be curtailed and urge them to reject any such changes to the tax code.
Click here to download and print the BHOF 2026 Policy Agenda.