Dive Brief:
- Doctors’ biggest priority in state legislatures this year is defeating scope of practice expansions, as nurses, pharmacists and other non-physician practitioners continue to lobby for more authority in providing care, according to an American Medical Association survey of U.S. medical societies released Friday.
- The highest number of respondents — 89% — cited that concern, which was followed in importance by Medicaid. Seventy-two percent of respondents said they’re focused on enhancing physician reimbursement and stabilizing funding amid steep cuts to the safety-net program from Republicans in Washington.
- Other high priorities include addressing physician shortages, improving telehealth flexibility across states and protecting public health as regulators in the Trump administration chip away at established policies, especially around vaccinations and reproductive health, the AMA found.
Dive Insight:
The AMA’s survey of 64 medical societies highlights doctors’ biggest priorities at the state level in 2026, including the areas in which they think there will be the most legislative activity.
“Across the country, physicians are bracing for a year of consequential policy decisions that will directly affect patient care,” AMA CEO Dr. John Whyte said in a statement on the survey.
Many of physicians’ concerns revolve around looming cuts to Medicaid, showing how difficult providers expect it’ll be to adapt to changes in the GOP’s so-called “Big Beautiful Bill” signed into law by President Donald Trump in July.
The tax and policy law includes roughly $900 billion in cuts to Medicaid, and is expected to boot 7.5 million people off of the safety-net insurance program over the next decade — slashing revenue and increasing uncompensated care spending for U.S. doctors and hospitals as they already struggle to absorb rising costs of providing care.
Almost three-fourths of polled medical groups plan to push Medicaid-related legislation at the state level this year in a bid to stabilize financing in the program — and brace for Medicaid work requirements, which kick in at the start of 2027, according to the AMA’s survey.
Beyond Medicaid, respondents also said they were focused on implementation of the “Big Beautiful Bill” more broadly, including how billions of dollars in funds for rural healthcare are going to be disbursed and changes to provider taxes in the controversial law.
“OBBBA implementation is poised to dominate health committees’ time in a sizable number of states,” the AMA wrote.
Other big topics of discussion in 2026 include addressing physician shortages, with physician groups planning to focus on expanding residency slots, improving graduate medical education funding and supporting loan repayment programs.
Physicians also want to work with states to hammer out licensure and telehealth issues, including through establishing new licensing pathways for doctors trained overseas and increasing flexibility for virtual care across state lines.
Doctors’ groups are also focused on shielding public health. HHS Secretary Robert F. Kennedy Jr. continues to overhaul U.S. vaccine and nutrition policy, often against the advice of established public health experts and medical groups. In January alone, the former environmental lawyer and anti-vaccine activist dramatically scaled back the vaccines recommended for children and reshaped the nation’s dietary guidelines to emphasize meat and dairy.
Physician groups also said they’re focused on health insurer reform, including in the areas of prior authorization and payment transparency, and on how regulators react to the use of artificial intelligence in the healthcare sector — both hot topics in the industry as commercial payers attempt to reform their businesses to combat waning consumer trust and companies go all-in on AI to cut costs and streamline clunky operations.
But interestingly, medical societies’ most-cited concern is shifting scope of practice laws. The healthcare services that professionals like nurse practitioners, physician assistants and pharmacists are allowed to perform are increasingly decided by state legislatures, and a majority of medical societies said they anticipate new legislation this year from those groups seeking expanded practice and prescription authority.
“Scope creep” — when non-doctors are increasingly permitted to perform work previously only doctors could do — is viewed by some physicians as an existential threat to the sanctity of the doctor’s role in the exam room. Physicians argue that their education and clinical training isn’t interchangable with that of other medical professionals, and granting nurses or physician assistants more power could harm patients.
Meanwhile, non-physicians argue they should be allowed to provide services to the full extent of their ability, and that expanding scopes of service is a key tool to expand healthcare access in underserved rural areas.
Still, in 2025 through early November the AMA worked with state medical associations to defeat more than 150 scope expansion bills in dozens of states. Though, some bills snuck through — legislation giving nurses, physician assistants and pharmacists more freedom to provide care passed in Oklahoma, Wisconsin, Arkansas, New Mexico, West Virginia, South Dakota and North Carolina last year.
