Why It Matters

The American College of Gastroenterology faces three interconnected challenges threatening its members’ ability to deliver patient care: inadequate Medicare reimbursement, insurance barriers to necessary procedures, and limited access to cancer screenings. Congressional momentum on all three fronts creates a critical window for ACG’s lobbying efforts.

While a 2.5 percent Medicare payment increase passed in July 2025, physicians still face a 33 percent inflation-adjusted decline since 2001—requiring structural reform. Meanwhile, H.R. 2433 would require physician-led prior authorization decisions, addressing ACG members’ core complaints. Multiple bipartisan bills—including the Colorectal Cancer Payment Fairness Act—are advancing to remove barriers to preventive screening.

By the Numbers

ACG spent $92,407 on in-house lobbying in the final quarter 2025, continuing a two-decade advocacy operation. The organization has maintained direct lobbying since 2004, accumulating over $11.3 million across 79 disclosures. ACG strategically complements internal advocacy with external firms including Alston & Bird LLP (nearly $4 million, 77 filings) and Squire Patton Boggs ($2.3 million, 32 filings).

The Agenda

ACG is lobbying on three core issues consistent across its two-decade advocacy history.

First, the organization pushes for fair Medicare reimbursement through legislation like the Medicare Patient Access and Practice Stabilization Act to address ongoing payment cuts.

Second, ACG advocates for removing barriers to colorectal cancer screening, supporting various versions of screening access legislation to remove co-pays and other barriers.

Third, ACG works to reform insurance utilization management practices, pushing for passage of the Safe Step Act and Improving Seniors Timely Access to Care Act to address prior authorization barriers.

Broader Context

ACG’s final quarter advocacy occurs amid extraordinary healthcare policy activity. Medicare physician payment reform dominates the agenda, with physician-lawmakers including Rep. Kim Schrier, M.D. (D-WA) and Rep. Greg Murphy, M.D. (R-NC) championing reform legislation.

Prior authorization reform is gaining traction through H.R. 2433, which would mandate physician decision-makers for Medicare prior authorization. Cancer screening legislation is advancing through multiple bills, including the Colorectal Cancer Early Detection Act and the Gerald E. Connolly Esophageal Cancer Awareness Act.

Between The Lines

Congress is actively advancing legislation directly aligned with ACG’s priorities. The Medicare Patient Access and Practice Stabilization Act addresses payment reform, while H.R. 2433 tackles prior authorization requirements.

Multiple colorectal cancer screening bills are moving forward, including the Colorectal Cancer Payment Fairness Act eliminating Medicare coinsurance and expanding screening access for younger populations. These represent significant bipartisan consensus on issues ACG has prioritized for decades.

Competitive Landscape

ACG’s priorities align with a broad coalition including the American Medical Association and more than 150 provider organizations coordinating Medicare reimbursement advocacy. On prior authorization reform, ACG joins roughly two dozen medical associations supporting H.R. 2433.

For cancer screening, ACG competes and cooperates with patient advocacy groups supporting the Colorectal Cancer Payment Fairness Act and related legislation. Healthcare industry lobbying surged 16% to $653 million in 2025’s first nine months, but ACG’s gastroenterology expertise and established congressional relationships provide unique positioning.

The Bottom Line

ACG’s $92,407 fourth quarter lobbying represents routine advocacy within an extraordinarily active healthcare policy environment. Key developments include Medicare’s temporary 2.5% payment increase while structural reform continues, multiple bipartisan prior authorization bills advancing, and significant momentum on cancer screening legislation.

The Multi-Cancer Early Detection Screening Coverage Act is described as "the single most popular bill" on early detection. ACG’s advocacy aligns with broader physician coalitions operating within a surging healthcare lobbying environment, with genuine legislative prospects across all core priorities.

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