As the nation’s physician shortage deepens and health AI continues to reshape the landscape of U.S. care delivery, doctors and medical society executives across the country have clearly identified their top state legislative priorities for 2026.
“Physicians are bracing for a year of consequential policy decisions that will directly affect patient care,” said AMA CEO and Executive Vice President John Whyte, MD. “This survey shows that state medical societies are united around protecting patient safety, strengthening Medicaid, and addressing a workforce crisis that is straining access to care.”
Dr. Whyte announced a new State Advocacy Accelerator Grant Program, which will “deliver targeted resources to help physicians drive real impact at the state level and advance smart, evidence-based policies that put patients first.”
According to survey results released in conjunction with the 2026 AMA State Advocacy Summit this week (executive summary and full results, in PDF), 89% of the state medical association and national medical association executives surveyed named scope of practice as their No. 1 priority this year.
More than 150 scope-creep bills were defeated in 2025, and there are no signs of letup for 2026 in nonphysicians’ perennial push to inappropriately expand scope of practice. Through its Advocacy Resource Center, the AMA works directly with national, state and specialty medical societies to enact state laws and regulations that protect patients and support physicians—and fight back against those that do not.
As part of its long-running efforts to fight scope creep, the AMA defends the practice of medicine against scope of practice expansions that threaten patient safety and undermine physician-led, team-based care. Last year, the AMA worked with more than 35 state medical associations and over 10 national specialty societies to defeat scope of practice legislation, and the AMA Scope of Practice Partnership provided 19 grants to help state advocacy efforts on this issue in 2025. The partnership has handed out $5 million in grants since its inception, and that effort will be stepped up, with AMA Board Chair David H. Aizuss, MD, announcing today that the AMA will commit $1 million annually to the Scope of Practice Partnership.
That money will “help us defeat scope expansions across every state that are putting patients at risk by allowing nonphysicians to do the work that only physicians are trained and educated to do,” Dr. Aizuss said. “This is a huge investment, demonstrating the importance of this issue for both patients and doctors.”
In the AMA survey, nearly one-third of state medical society respondents said they expect to work on scope of practice issues involving pharmacists in 2026, compared with 25% each who named matters relating nurse practitioners (NPs) and physician assistants (PAs). More than 20% of medical society executives said they anticipated advocacy activity involving optometrists, certified registered nurse anesthetists (CRNAs) or naturopaths.
A new dimension of the scope of practice issue will be explored in a session Friday at the State Advocacy Summit, which runs through Saturday at the Terranea Resort in Rancho Palos Verdes, California. More than 300 physician leaders and medical society staff are attending the AMA State Advocacy Summit. Attendees will:
- Hear from national experts on the critical issues impacting medicine at the state level.
- Strategize with advocacy leaders on their organizations’ state legislative and regulatory priorities.
- Network with other physician leaders and colleagues from across the country.
At a session Friday, the AMA will unveil new survey data showing that nurse practitioners and physicians assistants—predominantly trained to treat patients in primary care practice settings—are leaving primary care at high rates and, frequently, entering new specialty areas without additional training or certifications.
Experts at the panel discussion—moderated by AMA member Rebekah Bernard, MD—will unpack what the trends mean for patients, including the risks posed when health professionals without specialty training rapidly shift into new fields and what form state legislative responses might take to mitigate those risks.
Previous research has shown “a misalignment between nurse practitioner education, training and certification and the specialty or setting in which they practice, such that some nurse practitioners find themselves in the position of caring for a patient population or level of acuity in which they have received no formal education or training,” said an AMA Board of Trustees report adopted by the House of Delegates in 2024.
Learn more with the AMA about the vast differences in education and training between physicians nonphysicians.
Nearly 3 in 4 name Medicaid as top issue
Respondents to the AMA survey were asked to pick their top five state-level physician advocacy issues for 2026. Following scope of practice, the other agenda-topping issues were:
- Medicaid—72%.
- Physician workforce—67%.
- Medical licensure issues—67%.
- Public health—64%.
- Augmented intelligence (AI) in medicine—64%.
That Medicaid finished in a clear second place should come as no surprise given that H.R. 1—the massive budget-reconciliation bill enacted last July and dubbed the One Big, Beautiful Bill Act (OBBBA)—introduces sweeping changes to Medicaid that will reshape coverage, financing and program design across the country. As states move to implement these provisions, physicians and medical associations will play a critical role in ensuring that patient access to care remains strong, and program changes are carried out effectively.
The AMA has created a landing page outlining the changes to Medicaid, the Affordable Care Act and other key provisions of the OBBBA with easily digestible summaries and a one-stop shop for the AMA’s press statements and advocacy on the legislation that will have a major impact on the health care landscape for years to come.
Among the Medicaid changes coming in 2026 is an end to The American Rescue Plan Act of 2021’s incentive for states to expand their Medicaid programs to cover all adults with incomes below 138% of the federal poverty line.
The AMA has summarized the many changes to Medicaid financing (PDF), community-engagement requirements (PDF) and Medicaid and CHIP enrollment, eligibility and cost-sharing (PDF) and is providing its expertise to state medical associations and state lawmakers and regulators as they seek to mitigate the potential adverse effects of the OBBBA on health insurance coverage rates and access to care.
At a State Advocacy Summit session Friday, expert panelists will examine how states are responding to the new requirements, the practical implications for Medicaid programs, and the challenges and opportunities these changes present for physician advocates. Participants will gain insight into emerging state strategies, areas where physician advocacy is most needed, and ways to engage with policymakers to protect and strengthen care for Medicaid patients.
A separate session, also Friday, will examine the OBBBA’s impact on ACA Marketplace plans and the role of states and advocates in mitigating the impact of these changes and in protecting access to affordable coverage.
Hundreds of state bills on health AI
On augmented intelligence in medicine, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors. That includes recently launching the AMA Center for Digital Health and AI to give physicians a powerful voice in shaping how AI and other digital tools are harnessed to improve the patient and clinician experience.
By midyear 2025, 250 bills had already been introduced relating to health AI across 34 states, touching on transparency, consumer protection, payer use of AI and clinical use. Some existing state laws affecting health AI may be affected by the White House’s long-anticipated executive order on AI regulation, issued in December.
Health AI and harnessing innovation to improve care was the focus of the keynote address at the State Advocacy Summit, delivered by physician-scientist, bestselling author, Castleman disease survivor and Every Cure co-founder David Fajgenbaum, MD, MSc.
Meanwhile, medical licensure has been a mainstay for physician advocates at the state level, but a rising trend that is redrawing the picture relates to new licensing pathways for foreign-trained physicians. At last count, legislation that would create an additional licensing pathway for such doctors has been enacted in at least 18 states.
An AMA Council on Medical Education report (PDF) adopted in November by the House of Delegates details the legislative trend and the AMA’s active involvement in the Advisory Commission on Additional Licensing Models formed by the Federation of State Medical Boards, the Accreditation Council for Graduate Medical Education and Intealth. The commission has offered guidance on additional licensing pathways for physicians who have completed training or practiced medicine outside the U.S., which is covered in the AMA council report.
