Why It Matters
The American Chiropractic Association faces decades-long Medicare restrictions that limit what services chiropractors can bill. This effectively excludes seniors from broader pain management options. The ACA’s lobbying targets the Chiropractic Medicare Coverage Modernization Act (S.106/H.R.539), which would allow Medicare to cover all chiropractic services within a provider’s state scope of practice, not just spinal manipulation. The bill enjoys bipartisan support with 134 House cosponsors and 12 Senate cosponsors, while congressional allies promote non-drug pain alternatives amid the ongoing opioid crisis.
By the Numbers
The American Chiropractic Association reported $63,025 in the last quarter on lobbying spending, continuing over two decades of federal advocacy. Since 2003, the organization has filed 157 lobbying disclosures and spent approximately $5.9 million on advocacy efforts. The ACA relies primarily on its in-house lobbying team, though it has engaged external firms including Capitol Hill Consulting Group ($1.04 million across 31 filings).
Throughout 2025, the ACA maintained consistent lobbying on identical issues across all quarters, targeting the same primary legislation without major shifts in strategy.
The Agenda
The American Chiropractic Association is lobbying to expand Medicare coverage beyond current restrictions. The organization’s primary target is the Chiropractic Medicare Coverage Modernization Act of 2025 (S.106/H.R.539), which would allow Medicare to cover all services within chiropractors’ state scope of practice.
Currently, Medicare only covers spinal manipulation for subluxation—a restriction dating to 1972. The ACA argues this limits seniors’ access to non-drug pain management options already available through the VA and Department of Defense. The organization also supports the Alternatives to PAIN Act (S.475/H.R.1227), which would reduce cost-sharing for non-opioid pain treatments under Medicare.
Broader Context
The ACA’s last quarter 2025 lobbying unfolds amid significant federal momentum for non-opioid pain management alternatives. Congress has advanced bipartisan legislation on pain access, while the Trump administration has signaled openness to expanding Medicare benefit designs—including a reported pilot program to reimburse CBD treatments for seniors.
However, the ACA’s agenda faces headwinds. Medicare Part B premiums are climbing nearly 10 percent for 2026, and millions of low-income seniors have lost access to assistance programs, constraining appetite for coverage expansions. Over 150 scope-creep bills were defeated across 40+ states in 2025, reflecting fierce professional competition over healthcare authority.
Between The Lines
Congressional champions are vocally backing the Chiropractic Medicare Coverage Modernization Act. Rep. Brian Fitzpatrick (R-PA) stated it’s "long past time to eliminate outdated restrictions," while Reps. John Larson (D-CT) and Greg Steube (R-FL) highlighted how the bill aligns Medicare with modern healthcare. Sens. Richard Blumenthal (D-CT) and Kevin Cramer (R-ND) have expressed similar support.
The House Energy and Commerce Health Subcommittee held a January 8, 2026 hearing on "Legislative Proposals to Support Patient Access to Medicare Services," demonstrating committee interest in expanding access for seniors—directly supporting the ACA’s policy goals.
Competitive Landscape
The International Chiropractors Association is also lobbying to eliminate "long standing discriminations" in Medicare, seeking coverage for evaluation services and diagnostic imaging while pushing to improve veterans’ access. The two organizations have aligned their efforts around identical legislative priorities, demonstrating unified industry pressure on policymakers.
The Bottom Line
The American Chiropractic Association spent $63,025 on lobbying in the final quarter of 2025, continuing a two-decade effort to expand Medicare coverage. The organization’s advocacy aligns with bipartisan congressional momentum around the Chiropractic Medicare Coverage Modernization Act, which has strong cosponsorship support. However, Medicare affordability constraints and professional opposition could complicate passage.
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