Why It Matters

The American College of Physicians is fighting on three fronts threatening physician financial viability and patient access. Medicare physician payments remain inadequate despite a modest 2.5 percent increase, with practice costs outpacing reimbursement and 91 percent of physician services facing net reductions. Administrative burden—particularly prior authorization consuming significant physician time weekly—is driving physicians out of practice and exacerbating workforce shortages projected to reach 86,000 physicians by 2036.

The ACP’s dual-track approach—maintaining in-house advocacy while deploying external firm Tarplin, Downs & Young LLC—signals confidence that bipartisan congressional receptivity creates a genuine window for policy wins stabilizing physician practice economics.

By the Numbers

The American College of Physicians has filed 77 lobbying disclosures since 2004, spending more than $13.6 million through in-house operations. The newly filed Q4 2025 disclosure reported $85,529 in expenditures.

In a strategic shift, ACP expanded its approach in 2025 by retaining Tarplin, Downs & Young LLC, paying $160,000 over two quarters. This hybrid model represents a departure from historical reliance on internal staff alone.

ACP’s priorities remain consistent: 92 percent of issue filings focus on health care reform, while 8 percent address Medicare and Medicaid.

The Agenda

The American College of Physicians is lobbying on core issues affecting its 161,000 members. Primary focus areas include:

  • Medicare physician payment reform: Addressing inflation-adjusted reimbursement declines of 26-33% over two decades while practice costs rose 47%
  • Prior authorization burden reduction: Supporting legislation like the Reducing Medically Unnecessary Delays in Care Act of 2025
  • Physician workforce development: Advancing bills like the Kids’ Access to Primary Care Act to expand medical education funding
  • Telehealth access and coverage: Protecting reimbursement for remote care services

These issues align with broader congressional priorities across multiple healthcare-focused committees.

Broader Context

ACP’s fourth quarter 2025 lobbying occurs amid three interconnected healthcare pressures. First, the 2026 Medicare Physician Fee Schedule includes a 2.5% increase, but practice expense cuts result in net reductions for most services, with internists facing cuts of 5% or more.

Second, prior authorization burden persists. While 50+ major insurers pledged streamlining beginning January 2026, nearly 90% of physicians report the process remains extremely burdensome. CMS’s new WISeR Model extends prior authorization into traditional Medicare.

Third, workforce shortages are accelerating, with administrative burden significantly contributing to physician burnout.

Between The Lines

Congress is actively working on ACP’s lobbying priorities. On Medicare payments, Rep. Greg Murphy (R-NC-3), a physician, has led bipartisan stabilization efforts, though recent House spending bills excluded Medicare pay fix provisions.

On administrative burden, the Joint Health and Oversight Subcommittee heard testimony on prior authorization’s impact. Rep. Mark Green (R-TN-7) reintroduced the Reducing Medically Unnecessary Delays in Care Act, citing data showing physicians spend 16 hours weekly on administrative tasks.

For workforce shortages, Rep. Diana Harshbarger (R-TN-01) reintroduced the Rural Physician Workforce Production Act.

Competitive Landscape

ACP operates within a coordinated advocacy ecosystem. Corewell Health spent $270,000 quarterly on identical priorities, while the University of Pennsylvania spent $180,000 on overlapping issues. The American Osteopathic Association pursues similar priorities.

This alignment amplifies physician voices rather than creating competition, reflecting genuine consensus within the provider community.

The Bottom Line

ACP’s last quarter 2025 lobbying reflects unified physician advocacy around Medicare payment stability, administrative burden reduction, and workforce shortages. The organization’s dual approach—$85,529 in in-house lobbying plus new partnership with Tarplin, Downs & Young—combined with aligned advocacy from peer organizations, creates Capitol Hill pressure. However, competing fiscal priorities limit comprehensive reform prospects in the near term.

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