March 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 March for policies that impact you, your patients, and your community.

Welcome to Fighting for Family Medicine. I'm David Tulley, 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 March.

Chronic diseases now account 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 earlier this month. AFP'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 receives a small fraction of overall healthcare spending, even as it is asked to do more to manage chronic disease. Primary care is the front door to the healthcare system. This chronic underinvestment has led to workforce shortages, longer wait times, practice closures, and fragmented care that drives costs higher for everyone.

It also accelerates healthcare consolidation, which often makes profit an incentive rather than patient care. You can read Shawn's testimony in the show notes.

AAFP leadership met with lawmakers on Capitol Hill. To advocate for policies that improve patient access and strengthen the environment in which family physicians talked to lawmakers about policies that would make primary care function the way it's designed to.

One of the clearest messages delivered was that primary care only works when patients can afford to access care. We know that ongoing, coordinated care improves outcomes and reduces downstream costs. When patients face high-cost sharing or fear surprise bells, they delay follow-ups, skip labs, and avoid care coordination.

That breakdown doesn't just affect individual patients. It increases long-term systems costs. We told Congress that primary care must be affordable at the point of care if financial barriers interfere with continuity.

The AAFP also emphasized the importance of maintaining science-based vaccine policy.

Family physicians remain among the most trusted sources for vaccine guidance and delivery. When public policy is grounded in science and data, it reinforces patient trust when it isn't, confusion and mistrust follow.

Another key focus was targeted tax policy to support the primary care workforce. This includes incentives that support physicians practicing in rural, underserved communities, preserving independent and physician-owned practices, and strengthening care for vulnerable populations.

Several states have already explored or implemented versions of these approaches. The broader goal is recruitment, retention, and long-term sustainability of primary care where it's needed most.

Workforce policy starts long before someone opens a practice. It starts in medical school. A proposed department of education rule could significantly affect access to federal student loan programs for medical students, and that has serious implications for primary care.

Physicians are among the most likely professionals to carry student loan debt.

The majority graduate with both undergraduate and medical school debt. That financial burden already shapes specialty choice, practice, location, and long-term career decisions. If federal loan access narrows or repayment protections weaken, we risk further discouraging students from entering primary care, particularly those from communities already underrepresented in medicine.

The AAFP submitted a letter urging the Department of Education to protect medical students and future family physicians. Specifically, we asked the department to take the following steps. First, maintain access to graduate plus loans, or create a carve out that recognizes the unique clause, structure and length of medical training.

Second, exempting medical education programs from automatic loan proration that could force students into private lending or delay completion. And lastly, preserve safeguards so repayment plan transitions do not jeopardize public service loan forgiveness eligibility for many family physicians practicing in underserved areas.

PSLF is one option among many. It's what makes those career paths financially viable. When we talk about student loan policy, we are talking about the future availability of primary care in communities across the country.

AI is rapidly entering clinical workflows, and family medicine has a unique stake in how it evolves. Our specialty is built on relationships and continuity of care. Any technology introduced into that environment must strengthen those core functions. In 2023, the A FP developed guiding principles for AI implementation.

The foundation is simple. AI tools should be evaluated with the same rigor as any other clinical tool. Recently we submitted comments to federal health IT leaders outlining how AI should be integrated into care settings. Several themes stood out. First, AI technologies must be safe, effective. Fair and transparent innovation cannot come at the exposure of accountability.

Second, practicing physicians must be involved throughout the AI lifecycle from development to implementation. An A FP survey conducted with rock health found that many primary care physicians reported little to no involvement in AI related decision making. This can lead to AI tools being implemented that impede rather than improve clinical workflows.

Third, AI should enhance clinical practice, not add to administrative burden. The priority should be tools that streamline documentation, reduce clerical workload, and support clinical decision making. If AI adds clicks, dashboards, and compliance layers, it misses the mark.

AAFP also recommended modernizing payment policies so that small and independent practices can afford the infrastructure required for responsible AI integration without financial support, innovation risks widening the gaps between large systems and community based practices beyond AI.

Specifically, we continue to advocate for strong privacy. Security and transparency standards with the broader health IT certification program. Balancing innovation with patient protection and reduced administrative burden.

Too many Americans struggle to get the care they need. Patients face long wait times. High costs and care that doesn't always improve their health. At the same time, many physicians are burned out. Health services research helps find practical solutions to these problems. When funding is cut, however it becomes harder for our country to approve care and health outcomes.

The AAFP recently signed onto a letter to Congress asking lawmakers to fully fund the Agency for Healthcare Research and Quality, also known as AHRQ in the next fiscal year. AHRQ provides research and data that helps doctors, patients, and policy makers make smarter healthcare decisions. Its work helps ensure people get high quality care at a reasonable cost.

Our letter urged Congress to provide at least $500 million for ARC so it can continue research that makes care safer and more affordable. We also ask the U.S. Department of Health and Human Services to support adequate staffing and resources so AHRQ can effectively manage its programs, research grants, and science review process.

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.

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