The Rheum Advocate: January 29, 2026

ACR Sets 2026 Policy Priorities to Protect Patient Access, Strengthen the Workforce, and Support Research Funding

As the American College of Rheumatology (ACR) prepares for a complex year in health policy, our Government Affairs Committee (GAC) is focused on helping members and patients navigate a rapidly changing legislative and regulatory environment. This year’s federal and state policy changes are poised to reshape insurance coverage, care delivery, oversight, and public health across the healthcare system.

Each year, the GAC—comprising representatives from across the College—selects ACR’s top policy priorities to guide our advocacy efforts and resource allocation. For 2026, priorities center on protecting patient access to care, stabilizing physician reimbursement, and safeguarding research funding.

2026 Policy Priorities

• Reduce barriers to healthcare access, including patient-centered insurance reform, Medicaid access, and streamlined utilization management.
• Modernize Medicare reimbursement by eliminating the balanced budget requirement, ensuring fair evaluation and management code reimbursement, and supporting provider solvency to preserve patient access.
• Reduce barriers to treatment access, including reforming pharmacy benefit manager (PBM) practices, step therapy requirements, and maintaining access to vaccines, biosimilars, and office-administered treatments.
• Support research funding at the NIH, NIAMS, CDC Arthritis Program, and the DOD’s Congressionally Directed Medical Research Program.
• Expand the rheumatology workforce and strengthen training, education, and visa protections.
• Maintain access to telehealth, building on the recent two-year congressional extension of telehealth flexibilities.
• Increase transparency in Medicare Advantage to help patients better understand the coverage—and limitations—of their plans.

Patient access to care remains the top concern for members of the GAC, particularly as many anticipate significant Medicaid changes this year. Rising insurance costs continue to deter many patients from maintaining coverage or accessing the care they need—highlighting the need for patient-centered policy reform that prioritizes care over profit.

Another major focus is modernizing physician reimbursement. ACR will continue advocating to simplify administrative processes, stabilize federal program funding, and ensure fair compensation to preserve access to high-quality care.

Funding cuts to arthritis and rheumatology research in 2025 have also elevated research as a top advocacy priority for 2026. The GAC is committed to educating policymakers about the critical role research plays in advancing medical innovation, improving patient outcomes, and strengthening the nation’s economy.

Workforce shortages also remain a pressing issue. ACR supports expanding residency slots, increasing funding for graduate medical education, and bolstering loan repayment programs—all to ensure patients continue to have access to skilled rheumatology professionals.

Finally, ACR will continue advancing telehealth access and educating policymakers on the urgent need for transparency in Medicare Advantage plans to support patient decision-making.

The 2026 ACR Policy Priorities outline the College’s highest-level policy solutions for the coming year. ACR stands ready to support members with advocacy resources and expertise.

For questions or to get involved, contact the ACR advocacy team at advocacy@rheumatology.org.

Four Remaining Appropriations Bills Pass the House

The current debate around this funding package centers around the budget for the Department of Homeland Security in light of the recent events in Minneapolis. The ACR will continue to monitor the discussion and will keep members informed of legislative updates.

Highlights for the Rheumatology Community (*Reflects direct ACR advocacy requests in past policy fly-ins.)

Access to Care

• Two-year extension of telehealth flexibilities under Medicare.

Drug Pricing Reforms

• New transparency and reporting requirements for pharmacy benefit managers (PBMs) in Medicare Part D.*
• Decoupling PBM compensation from drug prices in Medicare Part D, marking progress on a long-standing ACR advocacy priority.*
• Prohibition of spread pricing in Medicaid.

Research Investments

• $48.7 billion for the National Institutes of Health (NIH), a $415 million increase over FY2025 levels.
• $9.1 billion for the Centers for Disease Control and Prevention (CDC), slightly above initial proposals.
• $10 million reinstated for the arthritis research line in the Department of Defense’s Congressionally Directed Medical Research Program.*
• Rejection of a proposed 15% cap on indirect research costs.*
• Continuation of current grant funding models, preventing the switch to lump-sum grants.

The ACR will continue monitoring and working with lawmakers to advance policies that reduce barriers to care, support innovation, and strengthen rheumatology practices nationwide.

RheumPAC 2026: Advocacy in an Election Year

2026 is an election year—and a major opportunity for RheumPAC to make a lasting impact on the future of rheumatology care. This year, we are prioritizing support for our champions in Congress, educating lawmakers about the issues that matter most to the rheumatology community, and strategically backing pro-rheumatology challengers and candidates in open seats.

The year is off to a fast start, and RheumPAC is already hard at work representing you in Washington. In January alone, RheumPAC staff attended multiple events to discuss policies that directly affect your practice and your patients—keeping rheumatology priorities front and center as Congress enters appropriations season.

Among the issues we are advocating for:

• Fair and sustainable Medicare reimbursement reform
• Strong and consistent biomedical research funding
• Reducing administrative burden for specialists
• Drug pricing reform and patient access protections

Learn more about the issues RheumPAC supports >

Spotlight on Elections and Lawmaker Education

RheumPAC is closely monitoring key U.S. House and Senate races across the country to help shape a more pro-rheumatology Congress in 2026. Whether identifying supportive challengers or open-seat candidates who share our priorities, our team will keep donors and advocates informed about the races that matter most.

After the election, RheumPAC will also play a crucial role in educating new lawmakers—making sure every freshman member of Congress understands the challenges facing rheumatology professionals and the patients they serve. A strong RheumPAC ensures that our voice is heard early and often in those conversations.

RheumPAC in Action: Early 2026 Highlights

Thanks to your support, ACR staff have already been able to engage directly with influential lawmakers this year, including:

• A bipartisan conversation with Rep. Brian Fitzpatrick (R-PA) on patient access issues.
• Lunch with Rep. John Joyce (R-PA), a physician-legislator with a deep interest in healthcare policy.
• A reception with the Tuesday Group, a caucus of pragmatic House Republicans often pivotal in shaping health and budget legislation.
• A discussion with Rep. Mike Carey (R-OH), who serves on committees shaping economic and healthcare-related policy.

These conversations help ensure that rheumatology remains a visible and influential voice in health policy decisions.

New Donor Perks and How to Get Involved

We are excited to introduce new donor perks for 2026, offering more ways to stay engaged and connected to RheumPAC’s work throughout this pivotal year. Investing early not only strengthens ACR’s advocacy but also helps maximize your impact during election season.

Your contributions will help ensure that the rheumatology voice remains strong on Capitol Hill. Join us in these efforts and make your contribution to RheumPAC today! Together, we can ensure rheumatology continues to have a strong, respected voice where it counts most—on Capitol Hill.

ACR Applauds FDA Proposal to Streamline Biosimilar Approvals, Calls for Guardrails on Non Medical Switching

The ACR has expressed strong support for the Food and Drug Administration’s (FDA) new draft guidance aimed at simplifying the approval process for biosimilar drugs—while urging safeguards to protect patients from insurer-driven treatment changes.

In a comment letter submitted January 20 to the FDA, the ACR praised the agency’s willingness to allow some biosimilars to demonstrate equivalence without requiring extensive clinical efficacy studies. The proposed change is expected to help lower costs and improve access to biologic therapies for people living with rheumatic diseases.

However, as the number of biosimilar options continues to grow, the ACR called for transparent safeguards to prevent repeated, non medical substitutions driven by short term payer contracts. The College emphasized that treatment decisions should remain between the patient and the treating rheumatologist—not a third party payer. The ACR also encouraged the FDA to monitor the long term impact of its deregulatory approach on both patient safety and market competition.

Read the full comment letter and ACR's policy positions on biosimilars >

From Funding to Impact – Key Themes Across State Rural Health Transformation Program Plans

In the last Rheum Advocate, we addressed the Rural Health Transformation Program (RHTP) grant amounts awarded to each state by the Centers for Medicare & Medicaid Services (CMS). While funding levels provide important context, dollar amounts alone tell only part of the story. To better understand how these resources will be used, we reviewed state plans to identify shared goals and emerging themes across the country.

State Plan Highlights

• Workforce development: Training, recruitment, and retention strategies to stabilize rural care teams
• Telehealth and technology: Expanded digital tools, remote monitoring, and broadband access
• Innovative care and payment reform: Promotion of value-based models and coordinated care networks
• Community-tailored services: Targeted approaches to chronic disease management and integrated behavioral health

Workforce Development – Recruiting and Retaining Providers

Strengthening the rural healthcare workforce is a central priority of the RHTP, reflecting persistent shortages of physicians, nurses, health professionals, and support staff in rural communities. States are using RHTP funds to support:

• Incentive and training programs for rural clinicians, including scholarships, loan repayment, and stipends tied to rural service commitments
• Recruitment strategies to help small hospitals and clinics attract providers who may otherwise avoid rural practice due to geographic isolation or lower compensation

For example, Pennsylvania’s RHTP plan emphasizes workforce initiatives such as scholarships, mentoring, short-term housing support, and targeted training for rural residents to fill service gaps in remote areas. Together, these efforts aim to reduce provider turnover, improve care continuity, and make rural practice more sustainable.

Telehealth and Technology Expansion

Many states are investing RHTP funds in telehealth services and digital health infrastructure to overcome geographic barriers that limit access to care. Common strategies include:

• Telemedicine platforms that connect rural patients with specialists in larger medical centers
• Remote patient monitoring technologies to support chronic disease management without frequent long-distance travel
• Broadband upgrades and cybersecurity investments to enable secure, reliable telehealth delivery

Texas, for instance, is prioritizing broad telehealth expansion by investing in digital care platforms that connect rural patients with primary, specialty, and behavioral health providers across its large geographic footprint, reducing travel burdens and improving continuity of care.

Innovative Care Models and Payment Reform

RHTP also encourages states to test new care delivery and payment approaches designed to improve quality while controlling costs. These efforts often include:

• Alternative payment models that reward value and outcomes rather than volume
• Coordinated care networks linking rural clinics, behavioral health providers, EMS, and hospitals
• Regional collaboratives that help rural communities identify priorities and share resources

Arkansas’s plan highlights a transition toward value-based payment arrangements as a way to improve long-term sustainability and strengthen care coordination across rural providers.

Community-Tailored Services

Beyond clinical capacity, RHTP emphasizes prevention and chronic disease management particularly for conditions that disproportionately affect rural populations. State strategies include:

• Funding evidence-based prevention programs to reduce avoidable hospitalizations
• Expanding access to behavioral health services in underserved rural areas

Kentucky is planning to establish Rural Community Hubs for Chronic Care Innovation, which will address chronic conditions through locally led, evidence-based strategies such as nutrition programs, physical activity initiatives, and self-management supports.

State RHTP plans reflect a shared recognition that improving rural health requires more than short-term funding—it demands sustained investments in people, technology, and care delivery systems tailored to community needs. Implementation that considers both the patient and provider voice will be critical to ensuring the effectiveness of these initiatives. The ACR will continue to monitor the implementation process to ensure these initiatives meet the needs of our members and the patients they treat.

ACR’s Voice Resonated Nationwide in 2025

The ACR continued to make a powerful impact throughout 2025, driving national conversations on patient access, Medicare reform, vaccine policy, and the future of rheumatology care. With 81 media hits, a total reach of 83.7 million people, and an advertising value equivalent (AVE) of $774,718, ACR’s advocacy and expertise remained front and center across major newsrooms and healthcare policy outlets.

From January through December, ACR experts appeared in national and regional publications, weighing in on some of the most consequential issues facing rheumatology patients and providers:

Priority Issues Elevated in the Media

• Medicare Physician Payment Reform: Coverage spanned outlets such as Bloomberg, MedPage Today, The Oklahoman, and Healthcare Dive, underscoring ACR’s persistent call to stabilize the Medicare payment system and protect access to care.
• Vaccine Policy & Public Health: Stories in Healio, Inside Health Policy, Medscape, and regional newspapers highlighted ACR’s concern over changes to the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) membership and potential risks for immunocompromised patients.
• Drug Pricing & Access: The widely picked-up investigative report “A plan to access cheap drugs backfires, leaving patient with $250,000 bill” reached more than 30 million readers, appearing in Bloomberg, The Seattle Times, KFF Health News, Medical Xpress, and more than a dozen regional outlets.
• Prior Authorization Reform: Media including Inside Health Policy and Healio covered ACR’s strong support for bipartisan reforms aimed at reducing administrative burden and ensuring timely patient care.

Rural Health & State-Level Media Advocacy

State-focused letters to the editor were published in major news outlets in Montana, West Virginia, Tennessee, Georgia, Washington, Missouri, and Nebraska. Written by ACR members, these pieces helped localize ACR’s advocacy efforts and connect with lawmakers and communities across the country.

With a strong media presence throughout 2025, ACR enters the new year with momentum, visibility, and a clear mission: championing policies that protect patient access, empower rheumatology providers, and strengthen the nation’s healthcare system.