February 2026 advocacy rounds

David Tully: 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 February 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 February.

David Tully: Earlier this month, the House passed the Senate-amended government funding package, and President Trump signed it into law, ensuring continuing operations for key federal agencies, including the Department of Health and Human Services.

The bipartisan agreement reflects successful cross-party negotiations and provides meaningful stability for health care programs that patients and clinicians rely on every day. The package includes several significant health care advancements, including a multiyear reauthorization of the Teaching Health Center Graduate Medical Education program through 2029, continued funding for community health centers and the National Health Service Corps through the end of this year, and a two-year extension of telehealth flexibilities through 2027. Together these provisions strengthen the primary care workforce, expand access in underserved communities and preserve virtual care options for patients.

The AAFP is calling on Congress to make health care more accessible and more affordable for patients across the country. In a recent letter responding to congressional hearings with health insurance executives, we laid out several insurance practices that are putting real strain on primary care and ultimately hurting patient outcomes.

We're seeing things like profit-driven practice acquisitions, downcoding of office visits that reduced payment for care. Physicians actually get lower physician payments in Medicare Advantage compared to traditional Medicare. There's also a chronic underinvestment in primary care overall. Along with utilization management and prior authorization requirements, that delay needed treatment.

On top of that, certain Medicare Advantage coding practices can fragment care instead of supporting whole-person continuous care. We've urged Congress to take action and advance specific bipartisan bills that would rein in these tactics and strengthen primary care. That includes legislation to speed up prior authorization decisions, ensure prompt and fair payment, reduce medically unnecessary delays in care and protect patients from harmful step-therapy requirements.

The bottom line: If we want better outcomes and lower costs, we must meaningfully invest in primary care and remove barriers that stand between patients and the care they need.

David Tully: According to a recent AAFP survey, nearly one in five patients in family medicine practices, or about 18%, are enrolled in Medicare Advantage plans. That means planned rules, network policies and administrative requirements have a real impact on access to care, continuity and practice workload. Over the last few years, the AAFP has been very supportive of a Centers for Medicare and Medicaid services proposal that would require Medicare Advantage plans to conduct an annual health equity analysis reporting on a plan's use of prior authorization. The annual health equity analysis would show prior authorization requests and denial rates for enrollees with a disability or low income compared with other plan enrollees.

This year, CMS proposed to eliminate this requirement. Our response was clear. We strongly oppose eliminating the health equity analysis and urge CMS to implement the report as previously finalized. We also encourage CMS to finalize proposals that would make it easier for patients to switch plans when their physician is no longer in network and use the star-ratings program to assess patient and physician experience.

Further action is needed to enforce commitments. Plans have meant to streamline, simplify and reduce prior authorization, and now is not the time to reduce transparency about the patient-physician experience. Our letter can be found in the show notes.

Programs such as the National Health Service Corps help support family physicians who practice in areas with the greatest need. The application window is now open for the Health Resources and Services Administration for National Health Service Corps loan repayment programs. Family physicians who serve in a health professional shortage area can receive loan repayment assistance through this program. Read more and apply for the program that works before your March 31 deadline. You can find more information about this in our show notes.

The AAFP is speaking about nondiscrimination protections and patient health. The AAFP joined the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians and the American Psychiatric Association in urging HHS to withdraw a proposed change to disability nondiscrimination rules under Section 504 of the Rehabilitation Act. The concern centers on a proposal that would explicitly exclude gender dysphoria from the definition of disability.

We warned HHS that this change could create confusion for both clinicians and patients, increase administrative complexity, delay care and weaken protections for vulnerable populations. Any policy changes should reduce barriers and supply timely, appropriate care for patients. You can find our full letter in the show notes.

David Tully: New research reinforces something family physicians see every day. Consistent access to primary care makes a measurable difference. A new report from the AAFP’s Robert Graham Center, titled “Investing in Primary Care: The Missing Strategy in America's Fight Against Chronic Disease,” looks at how primary care supports prevention, early detection and chronic disease management for conditions such as heart disease, diabetes and cancer.

Here are some standout findings from the report. Adults with a regular source of primary care have 20% lower odds of hospitalization and 11% fewer emergency department visits. Children with chronic conditions see about 50% fewer avoidable ER visits and hospitalizations when they have ongoing primary care access.

Total health care spending is dramatically lower, too: nearly 54% lower for adults and 40% lower for children. And patients with consistent primary care are much more likely to receive recommended preventive services. The takeaway is powerful. Investing in primary care isn't just good medicine; it's good policy and good economics.

You can read the full report in our show notes.

Registration for the Family Medicine Advocacy Summit is now open. The conference will take place from June 14-16 in Washington, DC, where you can bring your insight to help shape policy no matter where you are in your family medicine career. At FMAS, you'll have the opportunity to build powerful advocacy skills through dynamic, hands-on sessions and get up-to-the-minute insights from our policy experts on key legislation. Meet directly with your congressional offices and share your personal story with leaders who can make a difference. You can register today and get early bird pricing at the links in our show notes. Step forward, speak out and help us shape the future of family medicine.

David Tully: 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://aafp.org/advocacy . Be sure to check out the show notes for additional links. 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.