April 2026 advocacy rounds

As we get deeper into 2026, the AAFP is ramping up its advocacy efforts. It's time to recap the big and little ways the AAFP advocated in April for policies that impact you, your patients, and your community. Welcome to Fighting for Family Medicine. I'm David Tully. Vice President of government relations and a member of the AAFP's advocacy team.

Today, I'm going to recap the ways the AAFP advocated for family medicine during the month of April.

Family medicine depends on international medical graduates, also known as IMGs, to help meet patient care needs, particularly in rural and underserved communities. Ongoing visa processing delays, however, are creating uncertainty that can disrupt care, continuity, and contribute to existing workforce challenges, backlogs and uncertainty around J-1 waivers.

H-B extensions and green card applications are forcing some physicians to delay start dates, cut back hours, or leave their communities altogether.

We are not staying silent in our efforts to support these physicians; who are vital to communities across the country.

The AAFP recently led a coalition letter to the departments of Homeland Security and State, urging expedited processing of visas and immigration benefits for IMGs who are essential to the US physician workforce, particularly in underserved and rural communities.

Our letter called on the departments to use existing tools, such as premium processing and expedited review,to fast-track applications already credentialed for physicians ready to practice. We continue to work with federal partners to improve coordination across agencies and reduce immigration-related barriers to care.

You can read more about our advocacy efforts in the show notes.

A proposed workforce Pell rule would expand access to short-term training programs but exclude individuals who already hold graduate degrees like physicians. The AAFP warned the Department of Education that this could unintentionally block physicians and other professionals seeking to re-skill or shift into high-need areas.

We stressed that limiting federal aid based solely on credentials rather than financial need or workforce demand risks reinforcing existing inequities instead of addressing workforce gaps. You can read our letter in the show notes below.

Chronic Care Management, like care coordination, electronic care planning and managing transitions between clinicians is something that you do every day.

Chronic care management has been shown to improve patient outcomes, boost satisfaction, and reduce hospitalizations and emergency visits. That's why the AAFP supports legislation that would eliminate Medicare's 20% co-insurance requirement for chronic care management and remove a key barrier to expanding access to millions of patients who could benefit from coordinated care.

The AAFP recently joined nearly 40 other organizations in support of this legislation. Check out more in the show notes below.

The AAFP participated in an in-person convening focus on the Centers for Medicare and Medicaid Services’ new long-term enhanced ACO design model, also called the LEAD Model. We were joined by physician groups, accountable care leaders and federal officials to discuss the future of value-based care. The meeting highlighted a continued federal focus on strengthening accountable care.

The AAFP is actively collaborating with partners and federal officials to help shape LEAD implementation with a focus on supporting primary care led models, reducing administrative burden, and ensuring long-term stability for participating practices.

Let's break down some recent activity in the regulatory space that stands to impact you, your patients, and your practices.

First, I want to highlight some of the work the AAFP has been doing to combat administrative burden.

In recent comments to CMS, the AAFP supported efforts to reduce fraud, waste, and abuse, but cautioned that added documentation, audits and prior authorization requirements often miss the mark while increasing burnout and driving consolidation.

The AAFP opposed a proposed 340B rebate model from the Health Services and Resources Administration that would require community health centers to pay upfront for certain drugs and wait for reimbursement warning, which could strain resources and delay patient access.

On the public health front, we wrote to the Food and Drug Administration supporting stronger FDA oversight around e-cigarettes, particularly around flavored products that appeal to youth, while calling for clear evidence-based standards across all products.

We know that comprehensive data is essential to measure how successfully we recruit and retain primary care physicians. Did you know that the AAFP's Robert Graham Center has a graduate medical education impact quotient data tool? This is a critical tool designed to measure primary care output, particularly in high-need communities.

You can access the GME IQ tool at the link in our show notes below.

Chronic disease now accounts for 90% of our 4.9 trillion in annual healthcare spending. Yet the United States allocates less than 5% of total health expenditures to primary care, a figure that lags far behind other developed nations.

Last month, AAFP's, executive Vice President and CEO Shawn Martin testified before the House Energy and Commerce subcommittee on health for a hearing on the role that clinicians play in making healthcare more affordable for all Americans. In his testimony, Shawn outlined how primary care services receive a small fraction of overall healthcare spending, even as it is asked to do more to manage chronic disease,coordinate care and serve as the front door to the health system.

This chronic underinvestment has led to workforce shortages, longer wait times, practice closure, and fragmented care that drives costs higher for everyone. It also accelerates healthcare consolidation, which often makes profit and incentive rather than patient care.

You can read Shawn's full testimony in the show notes below.

Thanks for joining us today. You can find out what the AAFP is doing to advocate for you, your patients, and your practices, and how you can get involved by visiting our website at AAFP dot org slash advocacy. Be sure to check out the show notes for more links from today's episode. If you've enjoyed today's episode, let us know by dropping a line to aafpnews@aafp.org.

Be sure to share the episode with your followers on social media and tag the AAFP. We will talk to you soon.

Thanks for joining us today. You can find out what the AAFP is doing to advocate for you, your patients, and your practices, and how you can get involved by visiting our website at http://www.AAFP.org/advocacy. Be sure to check out the show notes for more links in the topics discussed today. If you enjoy today's episode, let us know by dropping a line to aafpnews@aafp.org.

Be sure to share the epic episode with your followers on social media. Tag the AAFP. We will talk to you soon.