Capitol Hill Report
Advocacy
Read the Academy's bi-weekly update on legislative and regulatory advocacy for neurology.
July 7, 2025
What’s in the big reconciliation bill?
We want to make sure you know we have your back. We’re actively responding, relentlessly pushing forward, and ensuring your voice is heard loud and clear on Capitol Hill. Please keep reading Capitol Hill Report—and tell your colleagues—for a rundown of how your AAN is in overdrive advocating on your behalf. We’re analyzing and monitoring all changes made by Congress and the administration to evaluate any impacts on neurology and the patients we serve. If your practice, research, or patients have been impacted by recent changes at the federal or state level, please let us know by emailing advocacy@aan.com.
Issue in focus
The One Big Beautiful Bill Act was signed into law on Friday, July 4, after weeks of intense negotiations. This lengthy reconciliation bill contains a number of health care provisions that may affect you and your patients. Read on for details on some of the key issues the AAN has been following.
What is a reconciliation bill, and why does it matter?
Reconciliation is a special budget law procedure that allows one expedited bill that only includes direct budgetary effects per fiscal year, which can pass the Senate with a simple majority rather than the usual 60-vote filibuster threshold. With Republicans winning unified control of Congress and the presidency, this process was central to the party’s legislative strategy.
The House of Representatives drafted the first version of the bill, which passed in late May and was sent to the Senate for amendments and passage. The Senate changed various provisions in the bill before it passed its version last Tuesday, and the bill was sent back to the House for a final vote. The House passed the Senate bill days later without changes, sending the package to President Donald Trump’s desk for his signature.
Medicare reimbursement
The final package includes a 2.5% increase to the Medicare Physician Fee Schedule conversion factor for 2026. While this is not a comprehensive solution to longstanding issues with the physician payment system, this is a provision that costs money to support physicians in a bill that largely is focused on cost cutting. Its addition shows the impact of AAN advocacy, as the first proposed version of the Senate reconciliation bill did not include any positive increase to the fee schedule.
The AAN will continue to work towards a long-term solution to Medicare payment reform. Conversations surrounding this issue have already been taking place amongst key congressional leaders, and we will continue to work with Congress on a meaningful solution.
Other notable provisions
The AAN has expressed concerns during the reconciliation process about the impacts of several provisions in the proposed bill language, and remains concerned about provisions ultimately passed that will impact:
Medicaid
- Requires states that have expanded Medicaid to conduct eligibility determinations twice a year rather than annually
- Amends eligibility for Medicaid and CHIP coverage among people who are not US citizens
- Limits retroactive Medicaid expansion coverage to one month prior to a person’s application date and retroactive traditional Medicaid coverage to two months prior
- Prohibits, for one year after enactment, Medicaid funds from being paid to certain prohibited entities
- Requires states to establish work requirements for low-income adults without dependents
- Allows states to impose additional cost-sharing requirements for the Medicaid expansion population
Federal support for student loans
- Terminates the authority to provide subsidized loans to undergraduate students or Federal Direct PLUS Loans to graduate or professional students after July 1, 2026
- Caps loan limits for graduate and professional students at $100,000 and $200,000 respectively
- Caps borrowing for parents up to $65,000 in Federal Direct PLUS loans, regardless of how many students the parent is borrowing for
Our advocacy staff and thousands of member volunteers are dedicated to advocating for neurology. Interested in joining the conversation on these important issues? Find out how to get involved, whether you have a few minutes to contact your representative or can commit to a full day or more for events like Neurology off the Hill.
Latest advocacy news
AAN partners on congressional briefing celebrating NINDS
The AAN partnered with the American Brain Coalition (ABC) late last month to sponsor a congressional briefing celebrating 75 years of the National Institute of Neurological Disorders and Stroke (NINDS). As part of the NIH, NINDS is committed to furthering our understanding of the brain and nervous system to reduce the burden of neurological disease. The briefing featured a panel of researchers and caregivers who showcased the breakthroughs made possible through NINDS funding and underscored the need for strong, sustained funding to build on this progress.
AAN reviewing new CMS WISeR model
The Centers for Medicare & Medicaid Services Innovation Center recently announced the Wasteful and Inappropriate Service Reduction (WISeR) Model, which expands prior authorization in Medicare fee-for-service for a number of procedures, including electrical nerve stimulator implants, skin and tissue substitutes, and knee arthroscopy for knee osteoarthritis. The model is set to go into effect on January 1, 2026, and providers in the six selected states will have the choice of either submitting a prior authorization request for the model’s selected items and services or going through a post-service/pre-payment review. The AAN is currently reviewing this model’s impact on neurological care delivery.
New AAN position statement on novel therapies
The AAN recently published a new position statement, This statement provides guidance to policymakers on a variety of therapies that may have neurological treatment benefits, but for which available evidence is limited or for which there is no FDA-approved indication.
What we're reading
-
CMS study: Healthcare spending likely to grow by 7.1% in 2025 ()
-
How Fast Is Too Fast for FDA Drug Review? (Op-ed, )
-
Global Health, Research and Trump Dominate Aspen Ideas: Health Conference ()
Past Capitol Hill Reports
2025
- June 23: AAN member highlight
- June 9: Why member advocacy is ‘mission-critical’
- May 27: House passes reconciliation bill
- May 12: President's proposed budget
- April 21: The state of Medicare and Medicaid
- April 7: AAN president highlights advocacy
- March 24: There’s a new chance to support neuroscience
- March 10: March 14 government funding deadline
- February 24: AAN members meet in Washington, DC
- February 11: Executive branch update
- January 20: New Congress, new plan
- January 6: Congress fails to address physician priorities
2024
- December 9: Key year-end issues
- November 25: Extending telehealth flexibilities
- November 11: What could fix physician reimbursement?
- October 21: Congressional lame-duck session
- October 7: Your advocacy impact
- September 23: Brain health for all!
- September 9: AAN comments on Medicare Fee Schedule
- August 26: Physicians are essential In local advocacy
- August 12: Ask Congress to take action for telehealth
- July 22: Urge Congress to prevent proposed cut
- July 8: Advocate for neurology from your home state!
- June 24: Crucial prior authorization bill introduced in Congress
- June 10: Senate group to discuss Medicare payment reform
- May 20: 30 years of Conrad 30
- May 6: Lobbyist for a Day
- April 22: Congress considers access to care
- April 8: AAN recommends more transparency in Medicare Advantage
- March 25: AAN identifies top advocacy priorities
- March 11: Congress acts on Medicare cuts
- February 26: Could your advocacy go even further at the state level?
- February 12: Neurology on the Hill preview
- January 22: Medicare reimbursement update
- January 8: 2023 Advocacy year in review
2023
- December 11: Take Action to Prevent Damaging Reimbursement Cuts!
- November 20: AAN Members Provide Perspective at AMA Meeting
- November 6: How Will the CMS Fee Schedule Affect You?
- October 23: Reps Hear Proposal to Cut 'Red Tape'
- October 9: Participant Goes from Training to Testimony
- September 25: AAN Leaders Take the Hill
- September 11: AAN Submits Comments on 2024 Medicare Physician Fee Schedule
- August 21: Proposed Code Will Help CMS Value Cognitive Care Services
- August 7: Reinforcements Are on the Way!
- July 24: AAN President Elect Testifies on New Alzheimer's Treatments
- July 10: FDA Approves Lecanemab for Alzheimer's Disease
- June 26: MACRA, Prior Authorization, and AMA Resolutions
- June 12: Debt Limit Deal Affects Dollars for Research
- May 22: Want Step Therapy Reform? Please Step Forward!
- May 8: Act Now to Protect Veteran Care, Medicare Reimbursement
- April 24: Do You Know the AAN's 2023 Advocacy Priority Issues?
- April 10: AAN Responds to Health Workforce Crisis Inquiry
- March 20: Working with CMS on Monoclonal Antibodies Coverage
- March 6: Support Your 180 Colleagues Now Advocating in DC
- February 20: Capitol Hill Report: AAN Addresses National, State Health Care Issues
- February 6: Confronting Prior Authorization Burden, End of PHE
- January 23: Advisory Committee Supports Medicare Reimbursement Increases
- January 9: Top AAN Advocacy Successes in 2022
2022
- December 23: Congress Enacts Bill with Key Advocacy Wins
- December 12: AAN Monitoring Lecanemab for Alzheimer's Disease
- November 21: How the Midterms Will Impact Neurology
- November 7: Advocacy Strengthens Neurology—Join Us!
- October 24: Urge Senate to Act on Medicare Payment Stability
- October 10: Get Involved in Neurology Advocacy
- September 26: Physician Lawmakers Seek to Stem Medicare Reductions
- September 12: AAN Comments on Proposed 2023 Medicare Physician Fee Schedule
- August 22: Administration Outlines Federal Response to Long COVID
- August 8: Congress Makes Progress on Neurology Issues
- July 25: AAN Urges Congress to Focus on Long COVID; Joined by 75 Organizations
- July 11: CMS Proposes Changes to Telehealth, E/M, QPP, More
- June 20: AAN Input Helps Shape AMA Policies
- June 6: Congressional Support Grows for Key AAN Legislation.
- May 23: It's Time for Neurology on the Hill!
- May 9: Focus Is on Three Issues for Neurology on the Hill
- April 25: Pushing Congress for More
- April 11: Congress Addressing AAN Priorities
- March 21: AAN Active on Legislation, Research Funding
- March 7: Members Make Their Advocacy Priorities Clear
- February 21: Legislation on Prior Authorization Gains Support
- February 7: Loosened Telehealth Policies in Peril
- January 24: COVID-19 Vaccinations, Aducanumab, and More
- January 10: Improving Care for Veterans With Neurological Conditions