Washington, D.C. – June 20, 2025 – The American Medical Association (AMA) today voiced significant concerns regarding the Senate version of the “One Big Beautiful Bill Act (H.R. 1),” sending a detailed letter to Senate Majority Leader John Thune (R-SD) and Minority Leader Chuck Schumer (D-NY).
The nation’s largest physician organization highlighted several provisions and omissions within the legislative package that it argues could have detrimental effects on patient access to care, healthcare affordability, and the stability of medical practices.
Key Areas of Concern Outlined by AMA
The AMA’s letter specifically detailed issues across multiple critical areas of healthcare policy:
* Medicaid and Children’s Health Insurance Program (CHIP): The organization raised alarms over legislative language that could negatively impact these vital programs. The AMA emphasized that changes in the Senate’s package would likely lead to reductions in Medicaid and CHIP funding. Such cuts, they warned, could precipitate significant coverage disruptions for millions of vulnerable Americans and create new obstacles for physicians and other healthcare providers serving these populations.
* Affordable Care Act (ACA) Marketplaces: Concerns were also noted regarding provisions impacting access to coverage through the Affordable Care Act (ACA) marketplaces, a key pathway for many individuals and families to obtain health insurance.
* Medical Student Loans: The letter addressed issues related to support for medical student loans, a critical factor in addressing physician workforce shortages and ensuring aspiring doctors can afford their education.
* Artificial Intelligence Regulation: A proposed 10-year moratorium on state-level AI regulation within healthcare was flagged as a point of concern, suggesting potential implications for innovation, safety, and oversight in the rapidly evolving field of medical artificial intelligence.
Omission of Medicare Physician Payment Reform
Perhaps one of the most significant concerns for the AMA was the absence of House-passed Medicare physician payment reform provisions in the Senate version of H.R. 1. The AMA has long advocated for structural changes to the Medicare physician payment system, which they argue is fundamentally broken.
The organization specifically highlighted the lack of language to permanently link annual physician fee schedule updates to the Medicare Economic Index (MEI), a measure of practice cost inflation. Without this change, physicians face ongoing financial instability in their Medicare practices.
The letter underscored the tangible impact of the current system, pointing to a projected 2.83 percent cut to Medicare payment in 2025 under current law. Furthermore, the AMA stated that Medicare physician payments have lagged 33 percent behind practice cost inflation since 2001 when accounting for cumulative MEI increases.
Potential Consequences for Patients and Providers
The core of the AMA’s message is the potential negative impact of the Senate bill on both patients and healthcare providers. Reduced funding for Medicaid and CHIP could mean fewer people have insurance, or face greater difficulty accessing care. Obstacles for physicians and other providers in these programs could strain the safety net.
The continued instability in Medicare payment, exacerbated by the lack of inflationary updates, poses a significant threat to the financial viability of medical practices, potentially forcing difficult decisions regarding staffing, technology investments, and even the ability to continue accepting Medicare patients. The AMA argues that these pressures ultimately affect patient access to care.
By formally communicating these concerns to Senate leadership, the AMA is urging lawmakers to reconsider key aspects of the “One Big Beautiful Bill Act (H.R. 1)” to prevent what they see as potential damage to the nation’s healthcare infrastructure and patient access to essential medical services.
