CMA to Congress: Act Now on Critical Health Priorities

Delayed Action Risks Patient Access, Physician Stability

As Congress returns from recess, the California Medical Association (CMA), with strong support from LACMA, is urging lawmakers to act swiftly on a slate of healthcare reforms that could dramatically impact access to care for millions of Californians.

At stake: health coverage for families, financial stability for physician practices, and timely access to care for seniors and underserved communities.

Protecting Coverage and Affordability

CMA is calling for the urgent extension of enhanced Affordable Care Act premium tax credits, which currently help nearly 2 million Californians afford health insurance. If Congress fails to act, these subsidies will expire—triggering premium hikes averaging 97%, or roughly $1,500 annually per family. Such a spike would push many to drop coverage, increasing pressure on physicians and hospitals already managing high levels of uncompensated care.

Stabilizing Medicare for Seniors

With Medicare reimbursement rates down 33% since 2001 and no adjustment for inflation, CMA warns that California seniors face growing barriers to care. A recent CMA survey found that 76% of physicians say Medicare no longer covers their costs, and nearly half report plans to reduce their patient load or retire early.

CMA is calling on Congress to:

• Provide an annual inflation-based Medicare physician payment update

• Waive the impending 4% sequestration cuts to Medicare

• Permanently extend pandemic-era telehealth waivers through the CONNECT for Health Act (HR 4206)

Without these measures, seniors could face appointment delays exceeding six months in parts of the state.

Strengthening the Physician Workforce

To address California’s ongoing physician shortage, CMA is also urging Congress to continue funding for:

• The Teaching Health Center Graduate Medical Education Program

• The National Health Service Corps, which provides scholarships and loan repayment for primary care physicians serving underserved communities

Cutting Red Tape & Lowering Drug Costs

CMA is advocating for bipartisan action to reform prior authorization delays in Medicare Advantage. The Improving Seniors’ Timely Access to Care Act (HR 3514/S 1816) would require faster plan responses, public transparency, and disclosure of AI tools used to approve or deny care. AMA data shows:

• 93% of physicians report care delays due to prior authorization

• 91% say the process negatively impacts patient outcomes

In addition, CMA supports the PBM Reform Act of 2025, aimed at lowering drug prices by banning spread pricing, increasing PBM transparency, and separating compensation from drug cost markups.

A Critical Window

In a formal letter to California’s congressional delegation, CMA emphasized that delays only increase uncertainty for patients and practices. Every week without action pushes more physicians toward early retirement and undermines California’s hard-won progress in expanding healthcare access.

“These reforms are essential to protecting care for millions of Californians, sustaining medical practices, and building the physician workforce our communities rely on,” said CMA President Shannon Udovic-Constant, M.D.

LACMA+CMA will continue to press lawmakers on both sides of the aisle to advance these reforms before year-end—when the stakes for physicians and patients grow even higher.