Oct. 3, 2025: National Advocacy Update

Annual Medicare open enrollment for 2026

The annual open enrollment period for the Medicare program will be Oct. 15–Dec. 7, 2025. During this time, people eligible for Medicare can compare 2026 coverage options online at Medicare.gov. They can use the Medicare Plan Finder to review different Medicare Advantage (MA) plans and take action to change from their current MA plan to a different MA plan, switch from Original Medicare to an MA plan, or switch from an MA plan to Original Medicare. The open enrollment period is also the time that people with Medicare can review their Part D prescription drug coverage. People who want to keep their current Medicare coverage do not need to re-enroll.

Although people cannot make new Medicare plan selections until Oct. 15, the Medicare Plan Finder will allow individuals to view plan details as of Oct. 1, and some patients may contact their physicians with questions about their options. For 2026, CMS is introducing new features to Medicare Plan Finder, including directory information about plans’ physician networks, an improvement long advocated for by the AMA. Also for 2026, CMS indicates that the Medicare Plan Finder will provide details about more supplemental benefits like weight management programs, enhanced security measures to safeguard Medicare accounts, and more filtering options to match beneficiaries’ specific needs.  

In addition to the Medicare Plan Finder, Medicare beneficiaries are encouraged to call 1-800-MEDICARE for help comparing plans and costs. 1-800-MEDICARE is available 24 hours a day, seven days a week, to provide help. The State Health Insurance Assistance Programs are also a great way for people to get unbiased help choosing the best Medicare coverage for their needs. Another resource is an AMA issue brief (PDF) comparing traditional Medicare and MA, which defines and explains factors like networks, cost-sharing, and Medigap plans that may play a role in patient decisions about how they want to obtain their Medicare coverage. 

AMA requests exemption from new policy limiting time J-1 physicians can remain in the U.S.

The AMA has signed onto multiple letters and submitted individual comments to the Department of Homeland Security (DHS) in response to a proposed rule that, if finalized, would limit the length of time that certain visa holders, including J-1 foreign international medical graduates (IMGs), can reside in the United States.

Both of the letters that the AMA signed on to, and the individual comments the AMA submitted (PDF), oppose the movement away from the current policy of permitting foreign IMGs to remain in the country for the duration of their medical residency program to a fixed admission period with recurring extensions and ask that J-1 physicians be exempt from this proposed change.

The AMA also submitted individual, detailed comments to DHS Secretary Kristi Noem requesting the same exemption to the proposed changes to the current Duration of Status policy.  One coalition letter (PDF) was signed by more than 40 national medical, hospital, and patient organizations, including the American Hospital Association, Association of American Medical Colleges, Physicians for American Healthcare Access (PAHA), and the American Academy of Neurology.

The other letter (PDF), led by the Coalition for Physician Accountability, was signed by 14 national medical organizations including Intealth, the Federation of State Medical Boards, the Accreditation Council for Graduate Medical Education, and the American Osteopathic Association.

Since 1978, foreign students that receive either F (typically undergraduates) or J visas (including foreign IMGs), have been permitted to remain in the United States until the completion of their educational program, known as their “Duration of Status.” This stipulation is imperative and ensures that IMGs are able to complete medical residency training with minimal interruptions. Under the proposed rule, foreign students would only be permitted to remain in the United States for a period of four years, irrespective of whether they come to the United States for undergraduate or medical residency. The visas, however, could be extended upon expiration. Yet, the unique nuances of how contracts for J-1 resident physicians work would likely require renewals on an annual basis.

The proposed changes to the Duration of Status policy were primarily crafted to accommodate the traditional undergraduate educational experience in the United States. As a result, these new, largely duplicative regulatory changes would make it virtually impossible for J-1 physicians to complete medical residency training in the United States.

J-1 physicians are already among the most highly vetted exchange visitors through Intealth certification, standardized examinations, SEVIS [Student and Exchange Visitor Information System] tracking, state training licenses, and institutional privileging. However, the proposed change would, as applied to physicians, create new patient-care risks with limited incremental oversight benefits. The proposal also confirms J-2 dependents receive no automatic employment authorization extension when an EAD expires, creating household instability and a documented deterrent to IMG recruitment and retention.

Nearly 17,000 J-1 physicians provide essential patient care annually in more than 770 teaching hospitals across 49 states, the District of Columbia, and Puerto Rico.  With a projected shortfall of nearly 86,000 physicians by 2036, there is a growing need for a larger physician workforce that the U.S. cannot fill on its own, in part because the U.S. physically does not have enough people in the younger generation to care for our aging country. J-1 physicians play a critical role in filling this void, especially in areas of the U.S. with higher rates of poverty and chronic disease. For example, between 2001 and 2024 almost 23,000 IMGs worked in underserved communities and nearly 21 million Americans live in areas of the U.S. where foreign-trained physicians account for at least half of all physicians. Moreover, in 2021, about 64% of IMGs were practicing in Medically Underserved Areas or HPSAs, with almost 46% of these IMGs practicing in rural areas.

As a result, the letters request that the proposed regulation be modified to exempt the J-1 visa category of “alien physicians” from any changes to the current Duration of Status regulation, since it is crucial that IMGs are able to complete their medical residency training with minimal interruption.

AMA seeks physician exemption from H-1B Visa Proclamation

The AMA led a sign-on letter with 57 national medical specialty societies to DHS concerning the Proclamation entitled, “Restriction on Entry of Certain Nonimmigrant Workers.” This Proclamation implements a $100,000 fee, to be paid by the prospective employer, upon initial application for an H-1B visa beginning on Sept. 21, 2025. The letter urged DHS to issue clarifying guidance stating that H-1B physicians’ entry into the U.S. is in the national interest of the country, thereby exempting them from the Proclamation and the $100,000 fee. 

In addition, the AMA has had multiple meetings with members of Congress to discuss this issue and explain why physicians should be exempt from this Proclamation. If you would like to reach out to your members of Congress, the AMA has also created a grassroots campaign on this issue. More information on this grassroots campaign can be found at: Be Heard | Physicians Grassroots Network. 

Release the Pressure Campaign showcased during Congressional Black Caucus Foundation’s Annual Legislative Conference

The AMA, through its Release the Pressure (RTP) campaign, sponsored an exhibit booth during the Congressional Black Caucus Foundation’s (CBCF) 54th Annual Legislative Conference (ALC), held on Sept. 24-28 at the Walter E. Washington Convention Center in Washington, D.C.  

The Congressional Black Caucus (CBC) is the legislative body of Black members of Congress. This year, the CBC is not only the largest Congressional Black Caucus ever, but also the largest caucus in all of Congress. The CBCF is a separate non-profit, non-partisan research and educational institute that supports the CBC. The mission of CBCF is to develop leaders, inform policy and educate the public. In a recent CBCF survey, over 97% of respondents identified health care as a key issue.  

The ALC drew more than 15,000 registrants, including local, state and federal officials, legislative staffers, physicians, medical students, public health professionals, community leaders, and advocates from across the nation. The goal of the AMA’s presence was to raise awareness, build relationships and encourage attendees to take the pledge for the Release the Pressure campaign. These efforts are part of the AMA’s ongoing advocacy to improve heart health and prevent cardiovascular disease on Capitol Hill, with federal agencies, and in local rural and urban communities.  

The booth became a hub of conversation, where visitors learned more about the AMA’s CVD resources and initiatives including: 

• Release the Pressure Campaign
• AMA’s MAP™ Hypertension Program
• AMA’s Maternal Health Advocacy materials
• Self-Measured Blood Pressure (SMBP) Validated Device Listing
• AMA’s SMBP Medicaid Coverage Landscape Analysis (PDF)
• Million Hearts Hypertension in Pregnancy Change Package 

More articles in this issue

• Oct. 3, 2025: Advocacy Update spotlight on the government shutdown
• Oct. 3, 2025: State Advocacy Update