Decarbonization and degrading infrastructure present twin challenges to the aging U.S. electrical grid, which is vital to the economy, national security, and public well-being. This article addresses challenges around transmission planning processes and policy options to improve these. Specifically, long-term regional transmission planning is hindered by conflicts over the equitable distribution of costs incurred and the benefits achieved by new development, as well as siting and permitting challenges. Policy changes that require comprehensive estimation of benefits and joint trans-regional evaluation can promote projects that fulfill grid requirements effectively and economically. In addition, increased regulatory direction and consideration for non-transmission alternatives (NTAs) and related distribution technologies could defer or replace the need for new transmission.