Aug. 22, 2025: National Advocacy Update

AMA-led Federation letters oppose federal bill expanding pharmacists’ scope of practice

The AMA remains committed to promoting federal policies that preserve patient access to physician-led teams as the primary way to provide high-quality patient care. In general, the AMA strongly opposes federal and state efforts to expand the scope of practice of non-physicians, typically referred to as allied health professionals, in areas that constitute the practice of medicine.   

Recent AMA-led letters to Congress in opposition to an active federal campaign to expand pharmacists’ scope of practice illustrates AMA’s continued commitment to this important advocacy pillar. On July 24, close to 80 national medical specialty societies and state medical associations cosigned a letter (PDF) to Reps. Adrian Smith (R-NE) and Brad Schneider (D-IL) in opposition to H.R. 3164, the Ensuring Community Access to Pharmacist Services Act (ECAPS). Shortly after the release of the AMA-led letter opposing the House bill, Senate Majority Leader John Thune (R-SD) and Sen. Mark Warner (D-VA) introduced the same legislation with a slightly different title, specifically S. 2426, the Equitable Community Access to Pharmacist Services Act (ECAPS).  The introduction of the Senate companion bill prompted AMA to quickly swing into action with a separate letter (PDF) of opposition that was also cosigned by close to 80 AMA Federation members and ultimately sent to both Senate lead sponsors on Aug. 20. 

Organized medicine is very concerned that this particular federal bill inappropriately expands the scope of practice for pharmacists with respect to testing and treating patients for influenza, COVID-19, RSV and strep throat. AMA, along with national medical specialty societies and state medical associations, have opposed previous iterations of ECAPS in past Congresses, as well. While the latest version of ECAPS was modified prior to its introduction in the 119th Congress, many key parts of the legislation continue to violate AMA policies.   

The bicameral letters highlighted the following reasons for opposition to ECAPS: 

1. It allows pharmacists to perform services that constitute the practice of medicine 

2. It would undermine the principle of physician-led, team-based care that is integral to improving quality, reducing costs and preserving patient safety.  

3. The bill still would establish a federal scope of practice standard. 

4. Pharmacists are already overworked and, along with lacking the requisite training, cannot take on this additional patient care responsibility. 

AMA will continue to work diligently to educate all members of the House and Senate on the dangers of ECAPS. AMA members are encouraged to contact their federal elected officials to urge them to oppose this particular piece of legislation focused on expanded scope of practice for pharmacists. 

Connected “MOM” Act reintroduced in the House

On Aug. 15, Reps. Lois Frankel (FL-22), Maria Salazar (R-FL), Kathy Castor (D-FL) and Julia Letlow (R-LA) reintroduced H.R. 4977, the bipartisan Connected Maternal Online Monitoring (MOM) Act to help pregnant and new mothers stay healthy and safe. The bill would require the Centers for Medicare & Medicaid Services (CMS) to identify and address barriers to coverage of remote physiological devices like blood pressure cuffs, continuous glucose monitors and pulse oximeters under state Medicaid programs to improve maternal and health outcomes for pregnant and postpartum women.  According to the Centers for Disease Control and Prevention (CDC), 60% of maternal deaths are preventable, and 40% of the births in the U.S. are covered by Medicaid.   

AMA President Bobby Mukkamala, MD, was quoted in the press release as saying, “this crucial bipartisan legislation will make a meaningful difference in the fight to prevent maternal mortality and morbidity. Patients and physicians recognize that telehealth and remote patient monitoring services offer effective and convenient health care. The AMA believes this legislation would significantly improve maternal and infant health outcomes for pregnant and postpartum women across the U.S., especially for those who are high-risk, lower income, and live in rural areas.”  

The AMA also supported the Senate companion bill, S. 141, when it was introduced by Sens. Cassidy, MD (R-LA) and Hassan (D-NH) earlier this year and will continue to work with the bill sponsors and Congress to see this critically important bill advance this session. 

Reintroduced Resident Physician Shortage Reduction Act would add 14,000 new Medicare-supported GME slots

On Aug. 19, the AMA sent letters of support to the House (PDF) and Senate (PDF) for the Resident Physician Shortage Reduction Act. The Senate bill, S. 2439, was introduced on July 24, and the press release included a quote of support from AMA President Bobby Mukkamala, MD. The Resident Physician Shortage Reduction Act would increase the Medicare-supported graduate medical education (GME) training slots available for medical students and address the shortage of primary and specialty care physicians across the country. In total, 14,000 new Medicare-supported GME slots (2,000 slots per year) would be added over seven years.  

The original House version of the Resident Physician Shortage Reduction Act, H.R. 3890, was introduced on June 10 with AMA support. In fact, a press release from the lead sponsors, Reps. Terri Sewell (D-AL) and Brian Fitzpatrick (R-PA), included a quote from then-AMA President Bruce A. Scott, MD. Yet, the inclusion of language related to Rural Residency Planning, Development, and Technical Assistance Programs prompted the bill to be referred principally to the House Energy and Commerce Committee, while the Ways and Means Committee only had secondary jurisdiction. To ensure the Ways and Means Committee retained primary jurisdiction, Reps. Terri Sewell and Brian Fitzpatrick removed that section and reintroduced the legislation. Both Reps. Sewell and Fitzpatrick serve on the House Ways and Means Committee. As a result, AMA submitted a new letter of support for H.R. 4731, which is the new bill number for the Resident Physician Shortage Reduction Act.  H.R. 4731 is identical to S. 2439 and identical to the bill language from the 118th Congress. 

The AMA looks forward to working with Congress to address these critical shortages. 

AMA testifies at public hearing on EPA endangerment finding

AMA Trustee Ilse R. Levin, DO, MPH & TM testified on behalf of the AMA at a public hearing held by the Environmental Protection Agency (EPA) on its efforts to rescind the 2009 Greenhouse Gas Endangerment Finding that serves as the prerequisite for the agency’s ability to regulate emissions from motor vehicles.  

Dr. Levin’s testimony (PDF) urged the EPA to reconsider its position and maintain the endangerment finding as well as greenhouse gas emission standards for vehicles. She cited the overwhelming scientific consensus confirming that global climate change is real, is largely driven by man-made greenhouse gas emissions, and is harming our health. She also referred to studies that transportation-related emissions—particularly from light-duty vehicles and medium- and heavy-duty trucks—are the largest source of greenhouse gas emissions in the U.S., and account for nearly 28% of overall emissions.  

In addition, Dr. Levin discussed the AMA’s declaration in 2022 proclaiming climate change a public health crisis and strong support for efforts to reduce U.S. greenhouse gas emissions. Her testimony emphasized that unless we act quickly to reduce greenhouse gas emissions, we will continue to see escalating health threats from climate change and be dooming ourselves and future generations with a crisis that threatens our health and the environment.  

Without the endangerment finding, the EPA would lack clear statutory authority under the Clean Air Act to regulate emissions from new motor vehicles and new motor vehicle engines. If the EPA’s rescission is finalized, the agency could remove all greenhouse gas standards, including all greenhouse gas standards for light-, medium- and heavy-duty vehicles and heavy-duty engines. 

New AMA issue brief on substance use, data and policy

The AMA released a new issue brief (PDF) this week to provide physicians, medical societies and policymakers with updated information about the broad range of substance use in the United States—and recommendations on how to address such use. The brief, “Substance use in the United States: An update on data, policy and future directions,” highlights that—after more than a decade of increasing opioid overdose deaths involving illegally-made fentanyl (IMF)—fentanyl-related deaths decreased almost 27% nationally from 2023-2024. The AMA welcomes the decrease in overdose mortality, although the epidemic of drug-related overdose deaths is far from over—and there are many different substances being used that represent current public health threats.  

The new issue brief provides additional background on polysubstance use, including new data from the 2024 National Survey on Drug Use and Health (NSDUH) that among people aged 12 or older, the percentage who used illicit drugs in the past year increased from 22.2% (or 62.0 million people) in 2021 to 25.5% (or 73.6 million people) in 2024. Other key findings from the NSDUH include:  

• Cannabis use increased from 19.0% in 2021 to 22.3% in 2024
• Prescription opioid misuse decreased from 3.0% in 2021 to 2.6% in 2024
• Hallucinogen use increased from 2.7% in 2021 to 3.6% in 2024
• Cocaine use decreased from 1.7% in 2021 to 1.5% in 2024
• Methamphetamine use remained at less than 1% from 2021 to 2024 

• Inhalant use prevalence was 1.1% in 2024 

The AMA issue brief provides additional information and policy recommendations for a wide range of substances, including xylazine, medetomidine, hallucinogens, stimulants, cannabis, kratom, tianeptine and inhalants.