AAFP Responds to House Budget Reconciliation Package

In a letter to congressional leaders, the AAFP outlined both support and concerns across several provisions in the package, particularly those affecting health care access, physician payment, small practices, nutrition programs and medical education.

• We appreciate that champions from Energy and Commerce included a modest provision to update Medicare physician payment. However, family physicians faced a 2.83% cut in the beginning of 2025 that has not been addressed by Congress and remains unresolved in this provision. Practices need an adequate inflationary update and comprehensive payment reform to survive and ensure that patients can access primary care.
• We urge Congress not to implement Medicaid reforms as written that would impose work-reporting requirements, more frequent eligibility verification, limits on state financing and penalties for states using their own funds to cover undocumented individuals.
• We applaud inclusion of the Primary Care Enhancement Act, which would allow individuals with health savings accounts to use those funds to pay for direct primary care.
• We’ve long supported the extension and expansion of the Affordable Care Act’s advanced premium tax credits (APTCs). These tax credits ensure that millions of low- and middle-income families continue to have access to affordable health coverage. Given that the APTCs expire at the end of this year, we again encourage Congress to incorporate APTCs into the reconciliation package.
• We oppose restrictive caps on federal student loans and the exclusion of medical residents from the Public Service Loan Forgiveness program.
• We are concerned that limiting cost increases to the Thrifty Food Plan will make it difficult for SNAP beneficiaries to afford a healthy, recommended diet.

The AAFP remains engaged as the legislative process proceeds and will continue to advocate to protect the financial integrity of federal programs while preserving access to care and strengthening physician practices.