2020 will bring legislative turmoil as the Affordable Care Act (ACA) returns to the US Supreme Court and election-year rhetoric thrusts Medicare for All and healthcare job growth onto center stage. Set against this backdrop, price transparency rules will take effect, rounding out a year that will end with a newly elected president and potentially an entirely new healthcare legislative agenda. Healthcare leaders should read this report to ensure that legislative turmoil does not undermine their growth efforts.