Why It Matters
American Choice Healthcare’s entry into federal lobbying comes as the ACO REACH program faces a December 2026 expiration date, creating urgency around program extension. The organization is betting that experienced representation from Nelson Mullins Riley & Scarborough LLP will help shape pending legislation on ACO operations and quality reporting.
As a first-time federal lobbyist, American Choice Healthcare is competing with well-funded players like Agilon Health and AMGA who collectively spend hundreds of thousands quarterly on similar advocacy. Key legislative targets include H.R.4773 (improving beneficiary assignment to ACOs) and H.R.5347 (providing ACO quality reporting flexibility).
By the Numbers
American Choice Healthcare is launching its advocacy efforts in 2025 with no prior lobbying history. The organization has retained Nelson Mullins Riley & Scarborough LLP, a major Washington lobbying power with over $50 million in reported fees since 2004.
The engagement is staffed by lobbyist Jacob Louis Kohn, who brings diverse lobbying experience since 2021 with reported fees exceeding $1.8 million. American Choice Healthcare competes for policymaker attention alongside established organizations including Agilon Health Inc. ($190,000 Q2 2025), AMGA ($161,139 Q3 2025), and America’s Physician Groups ($160,000 Q3 2025).
The Agenda
American Choice Healthcare is lobbying specifically on the ACO REACH model, a value-based care program for Medicare beneficiaries. The ACO REACH program is designed to improve care coordination and health outcomes while holding provider groups accountable for both quality and total cost of care. The organization will engage on matters including program operations, payment structures, reporting requirements, and health equity provisions.
Broader Context
American Choice Healthcare’s lobbying debut arrives amid significant policy uncertainty. The ACO REACH program faces a December 31, 2026 expiration date, while CMS simultaneously proposed removing health equity adjustments from ACO quality scores starting in Performance Year 2026—a significant reversal of the model’s foundational design principles.
Congress is actively focused on Medicare cost containment, with the House Ways and Means Committee’s Health Subcommittee highlighting chronic disease as a fiscal crisis with projected costs of $3 trillion through 2030. The organization’s timing—effective January 1, 2025, coinciding with the new Congressional session—suggests strategic positioning to influence regulatory and legislative decisions that will determine ACO REACH’s survival.
Between The Lines
Congressional activity surrounding value-based care is intensifying at a critical moment for ACO REACH. The House Ways and Means Health Subcommittee held a hearing on modernizing healthcare focused on chronic disease costs—themes central to ACO missions. Several bills directly affect ACO operations: H.R. 4773 expands beneficiary assignment, while H.R. 483 and H.R. 5347 provide flexibility in quality reporting.
Competitive Landscape
American Choice Healthcare enters a crowded advocacy space dominated by established healthcare provider organizations. America’s Physician Groups actively lobbies on ACO REACH issues, spending $160,000 in Q3 2025. Agilon Health Inc. advocates on ACO REACH and physician payment reform, spending $190,000 in Q2 2025. These established stakeholders collectively shape debate around ACO policy, requiring American Choice Healthcare to differentiate its positions within this competitive environment.
The Bottom Line
American Choice Healthcare’s timing reflects urgency: the program expires December 31, 2026, forcing participating organizations to either secure extension or manage transitions. Congress is focused on Medicare cost containment—a theme favorable to value-based care models.
Spot something wrong? Report an issue with this article