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Today, the House of Representatives passed the government funding package H.R. 1, the One Big Beautiful Bill Act, with several provisions important to ASA, including reforms to Medicare physician payment, student loans and Medicaid.
ASA is pleased that this legislation, which had already passed the Senate, includes a provision with Medicare physician payment reform, known as the “Doc Fix,” albeit only a one-year patch. In the final version of the legislation, the Medicare physician payment would be increased 2.5% for 2026, following a more than 2% reduction for 2025.
ASA and other physician organizations worked closely with the House Congressional GOP Doc Caucus to secure physician payment provisions in the House-version of H.R. 1. This earlier version would have permanently tied future physician payment updates to a partial Medicare Economic Index update starting in 2026 and continuing into perpetuity. The provision would have represented an historic first-time, mandatory, annual inflation update in Medicare physician payments.
Unfortunately, no provision on Medicare physician payment was initially included in the Senate version of H.R. 1. In response, ASA co-led a communication with a powerful coalition of 75 national medical organizations to request the House-passed provisions be included as the Senate reconciliation package. ASA was pleased the Senate then amended their legislation in response to include a small payment adjustment for 2026. This version was included in the legislation that passed the House and will now go to the President for his signature. While ASA is encouraged that an adjustment for 2026 was included, a long-term solution has not yet been reached to reform the Medicare physician payment system to include an annual inflation adjustment. ASA will continue to advocate for a policy that creates stability for physician practices.
In addition to Medicare provisions, ASA also worked to address other provisions impacting anesthesiologists, other physicians and patients. Most notably, ASA raised concerns about significant changes to the Medicaid program. In May, ASA joined over 20 national medical organizations to express concerns about the impact of Medicaid changes, stating concerns “that several Medicaid proposals could disrupt coverage for vulnerable populations by shifting significant costs to states without a clear, evidence-based path to maintaining continuity of care.” ASA also worked with a coalition of other stakeholders to address threats to the future physician workforce. The final version of H.R.1 also includes several provisions that impact student loan programs; ASA along with other leading medical organizations had urged Congress to safeguard critical financial aid programs.
In light of the contentious nature of H.R. 1, it remains possible that some of the health-related provisions will be revisited in the future as their impact becomes evident.
H.R. 1 is expected to be signed into law by President Donald Trump on Friday, July 4. ASA will continue to review the provisions and their impact on ASA members.
Date of last update: July 3, 2025
