Why It Matters

The American Academy of Orthopaedic Surgeons is escalating its defense appropriations strategy at a pivotal moment. The organization has lobbied for over two decades, spending $5.9 million since 2003, primarily targeting federal funding for the Peer-Reviewed Orthopaedic Research Program (PRORP) within the Department of Defense.

Congress is increasingly alarmed about military medical readiness degradation from years of budget cuts. Recent Senate hearings documented how the "peacetime effect" erodes specialized surgical skills when combat experience dries up. Lessons from Ukraine underscore the stakes for orthopedic trauma care capability.

By the Numbers

The American Academy of Orthopaedic Surgeons has filed 114 total lobbying disclosures and spent $5.9 million on lobbying since 2003. The organization uses both in-house teams (76 disclosures) and external firms including current partner Hart Health Strategies Inc.

The new engagement with SL Strategies—effective June 23, 2025—focuses on FY26 Defense Appropriations bills with three lobbyists, including Jordan Tenenbaum, who has extensive experience with the Arthroscopy Association of North America on DoD appropriations.

By hiring SL Strategies LLC, AAOS is adding specialized firepower to existing efforts. The new firm brings critical assets: former Senate Appropriations Committee staffer Sara Love Rawlings and former Senate HELP Committee health policy director Mary Moody Johnson.

This represents AAOS’s most focused defense appropriations push yet.

The Agenda

AAOS is lobbying on FY26 Defense Appropriations bills, focusing on federal budget and defense spending. Their primary target remains securing funding for PRORP—a competitive Defense Department grant program funding research on extremity war injuries and orthopedic trauma care. Beyond defense appropriations, AAOS has previously lobbied on Medicare reimbursement reforms and healthcare quality measures.

Broader Context

Congress is reassessing military medical readiness after years of cost-cutting. During the Biden administration, Deputy Defense Secretary Kathleen Hicks directed the Defense Health Agency to bring at least 7% of patients back to military health facilities by 2026. The "peacetime effect"—degradation of specialized surgical skills during periods without active conflict—has emerged as a key concern.

The ongoing war in Ukraine has reinforced congressional interest in combat casualty care capability. AAOS operates within a coalition including the University of Texas System and American Physical Therapy Association, all advocating on military orthopedic research.

Between The Lines

Recent Senate Armed Services Committee hearings highlighted how military surgeons lack critical clinical experience in trauma and orthopedic care. S.Amdt. 3160 to the National Defense Authorization Act specifically calls for briefings on expediting medical prototypes for combat casualty care.

Multiple members have met with AAOS state chapters, including Rep. Carol Miller (R-WV-1) and Sen. Jim Justice (R-WV), signaling receptiveness to the organization’s priorities.

The Bottom Line

AAOS hired SL Strategies to target FY26 Defense Appropriations funding for military orthopedic research. The move adds specialized expertise at a moment when Congress is reassessing military medical readiness after Pentagon budget cuts. The hiring signals AAOS’s priority focus on securing continued PRORP funding in a competitive appropriations environment.

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