Family Medicine Advocacy Rounds, October 2025

Family physicians concerned about shutdown's impact on patients

In the face of a government shutdown, our ask is clear: Congress must safeguard the programs that keep care within reach. Funding for the Teaching Health Center Graduate Medical Education program and the Community Health Center Fund is essential, not just for training tomorrow’s primary care physicians but also to ensure that every family has a place to turn when they need help. Additionally, telehealth serves as a lifeline for so many; preserving flexibility and access is crucial. Read our full statement here, and read our letter to the administration here.

We are particularly concerned about the announcement that the Centers for Medicare and Medicaid Services will hold claims for Medicare services impacted by the expiring programs, including telehealth services.

AAFP weighs in on new proposed rules impacting IMGs

Why it matters:

The health of our nation depends on a strong primary care foundation. Despite overwhelming evidence to support primary care as the solution to the chronic disease crisis, it is projected that the U.S. will face a shortage of up to 40,000 primary care physicians by 2036.

Placing unnecessary restrictions on U.S. visa programs could discourage international medical graduates from entering family medicine or accepting positions in high-need areas, which would exacerbate existing workforce shortages, limit communities’ access to essential care and compromise public health outcomes.

What we're working on:

• AAFP wrote a letter to the U.S. Department of Homeland Security, as well as joining two sign-on letters, opposing a proposed rule to force non-U.S. medical residents to reapply for their visas after four years. Currently, IMGs visas are approved for the duration of their program, no matter how long the program is. If finalized, this rule would have far-reaching consequences for the primary care workforce. 
• We urged DHS to recognize IMGs’ importance in building a strong primary care workforce and to acknowledge how transparent, clear visa processes contribute to expanding that workforce. 
• AAFP urged DHS to use its authority to advance visa policies that support medical students, residents and physicians being able to serve U.S. patients and communities. 
• AAFP also wrote a letter and signed onto a joint letter with the American Medical Association pushing back against new rules that require a non-U.S. citizen applying for a new H-1B visa to pay a $100,000 fee. 
• The letter explains that doctors, including family physicians, are essential to our country and should be excluded from this requirement. 
• It also points out that physicians who hold H-1B visas are especially important in rural and underserved communities, and that states with more H-1B visa-holding doctors usually have fewer physicians per capita, making the contributions of IMGs even more critical.

AAFP endorses bipartisan Safe Step Act 

Why it matters: 

Step therapy is a prior-authorization policy that requires patients to try and fail one or more insurer-preferred treatments before coverage is granted for the medication originally prescribed by their clinician. While intended to reduce unnecessary utilization, these protocols too often jeopardize patient health, increase administrative burdens for physicians and undermine continuity of care. 

What we’re working on: 

AAFP applauds Congress for reintroducing the Safe Step Act, which would limit the use of step-therapy protocols to ensure that patients have access to treatment. This bipartisan legislation is a concrete step toward minimizing care delays for patients.

AAFP: Linking vaccines to autism is unproven and dangerous

Following remarks from the president and the Health and Human Services secretary, AAFP doubled down: Vaccines do not cause autism and taking acetaminophen while pregnant does not cause autism. These claims risk public health by causing people to suffer, delay or defer vaccination out of fear. Read our full statement.

AAFP will always be an agent of truth when it comes to public health. The 2025 Edelman Trust Barometer found that 82% of respondents trust their doctor more than any other source of medical information, including the internet and family and friends.

Sarah C. Nosal, MD, FAAFP, takes office as AAFP president

On October 6, Sarah C. Nosal, MD, was installed as AAFP president. Nosal, a family physician in Bronx, New York, brings nearly two decades of experience serving diverse and under-resourced communities, as well as state and national advocacy and leadership. Nosal is vice president for innovation and optimization and chief medical information officer at the Institute for Family Health, a network of federally qualified health centers spanning the Mid-Hudson, Bronx, Manhattan and Brooklyn. 

The AAFP also announced its 2025-26 officers and board members. Read our full press release here.

What we're reading

AAFP released fall immunization recommendations. "History shows us that vaccines have eradicated diseases that were disabling and deadly in the past, and we can keep it that way if we continue to vaccinate," said Margot Savoy, MD, MPH, CPE, chief medical officer of AAFP.

AAFP Board Chair Jen Brull, MD, spoke with NPR about changing public health guidance, what doctors are hearing from patients and how to best navigate changes. “If you hear something, wherever that source is — whether it's the television, TikTok or a headline — and you have a question about it, that's the time to have a conversation with the person who knows your health best,” she said. 

Dr. Brull wrote in the Oklahoman about the importance of family physicians as trusted messengers. “The expertise your physician brings and the self-advocacy you bring to appointments are what helps us navigate the uncertainty and questions — big or small,” she wrote. 

Robert Graham Center Director Yalda Jabbarpour, MD, spoke to Medscape about how Medicaid cuts reflect a “deeply concerning trend” in health policy: the “systematic underinvestment” in primary care. “At a time when more than a third of adults and 15% of children lack a usual source of care, we should be expanding access — not restricting it,” she said.

For the latest policy updates impacting family medicine, follow us at @aafp_advocacy.