| campaigning-for-medicine | Campaigning for Medicine | Latest_News | Shared_Content/News/Latest_News/2026/campaigning-for-medicine | <div class="col-md-12">
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<h5>Apr. 28, 2026</h5>
<h2>Campaigning for Medicine</h2>
<p><em>
At a time when science is under assault and health care faces federal cuts, physician participation in the political process is more important than ever.
</em></p>
<p>
By John Gallagher
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<em>Members only; sign-in required.</em>
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<p>
The midterm elections are just months away, and just as it has in past years, health care is likely to be a hot topic. Changes to Medicaid and insurance coverage made by Congress last year with the passage of H.R. 1 have already become an issue in federal campaigns nationwide. Meanwhile, at the local level, candidates will have to grapple with how Washington will implement those changes and mitigate some of the negative impact that they may have on patients, to say nothing of the state budget.
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"There is still so much left to untangle," Alex Wehinger, associate director of legislative and political affairs at the WSMA, says of the new law. Some of the issues relate to federal distribution of funds, but others are structural, including imposition of a work requirement for some Medicaid recipients. The result will put the Legislature in a tough spot. "The impacts will be felt heavily in the state. Combined with the existing pressures on the state budget, it will create a perfect storm for a really challenging dynamic," Wehinger says.
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Yet despite the stakes involved, to some extent physicians remain underrepresented in the conversation despite the expertise that they can bring to it. There are 20 physicians in Congress, including Rep. Kim Schrier of Washington, who is co-chair of the Congressional Doctors Caucus. There are currently no physicians in the Washington State Legislature.
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In terms of political activity, physicians are often outstripped by other groups. Some political action committees, or PACs, the entities that allow nonprofits to support candidates, are much more flush with money to influence the conversation.
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"Whenever there's an issue that comes up, there are many other groups that aren't physicians that are going to jump in and push really hard on the other side," says Elizabeth Peterson, MD, a pediatric plastic surgeon based in Spokane. Dr. Peterson has served on the board of the Washington Medical Political Action Committee, or WAMPAC, the nonpartisan political campaign arm of the WSMA, which was established to help identify and support candidates for political office in the state whose priorities align with the house of medicine. "Physician groups have always lagged behind attorney and nursing union groups, who therefore have more to say on those issues."
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WAMPAC is governed by a board of 12 physicians, one from each of the state's congressional districts and two at large. The board makes decisions about engagement in campaigns and helps direct WAMPAC's campaign work. The PAC also has a Diamond Club for physicians interested in getting more involved politically. At elevated contributions, the club provides insider updates about the political landscape, as well as invitations to events with candidates and elected officials.
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<h3>A high-stakes midterm</h3>
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The full picture for the current election cycle for Washington state offices is only emerging now. "At the state level, more than two-thirds of the Legislature will be up for election," says Wehinger, who also serves as the director of WAMPAC. "We know that some folks are retiring or running for other offices. There's no shortage of offices that will be on the ballot. It's just the 'who' that is to be determined." (The deadline for candidate filings in the state is May.)
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However, the general outline of the election cycle is clear. Midterm elections generally have a lower turnout, although there is some indication from recent special elections around the country that this year may be an exception. The party holding the presidency tends to lose seats. Districts that swing between Republican and Democratic candidates are increasingly rare. "A moderate Democrat versus a progressive Democrat is more our version of a swing district these days," says Wehinger.
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Health care promises to be a major campaign issue. "Every election has significant influence over the political landscape, and that impacts health care in the state," says Wehinger. In particular, the state is still sorting out the
impact of H.R. 1 passed by Republicans last year. The Congressional Budget Office has stated the law will reduce federal spending on health care by over $1 trillion and increase the country's uninsured by 10 million.
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<p>
Clearly, a lot is riding on the election. But as much as the focus is on the ballot box, just as much work—if not more—happens outside of the election. It's not simply a matter of waiting for the results to roll in. Meeting with candidates
to help them understand the issues and then working with legislators on measures important to patients and physicians may not be as visible, but both are critical parts of the process.
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"People who don't have a background in health care and health care policy are going to make decisions," says Wehinger. "The 360-degree view of advocacy is that it doesn't start on day one of the legislative session. It's about getting to meet these people and share WSMA's issues and priorities so that we have an established relationship when those candidates turn into legislators."
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Compared to the federal level, state legislators and candidates simply do not have the necessary depth of expertise on staff. "State legislators don't have the requisite expertise to inform their decision-making," says Dr. Peterson. "They don't have the staff to resource it."
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Nathan Schlicher, MD, JD, a senior vice president at TeamHealth, has a unique perspective on the electoral process: not only is he an emergency department physician at St. Joseph Medical Center, a part of Virginia Mason Franciscan Health, he is also a former member of the Washington State Senate. "Most people who serve at the state level are doing it for the right reasons," he says. Still, serving in the Legislature was "eye opening."
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"Think about the breadth, scope, and depth of government," he says. "You only have 147 elected people across two chambers, and there are only one or two people who are experts in each caucus or each body that other members rely upon."
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<h3>State impact on day-to-day practice</h3>
<p>
Certainly, the federal government has a huge impact on what happens in every state. That's especially true at a time when health care and evidence-based medicine are under assault at the federal level. "I see the federal government
cutting back on Medicaid and Medicare reimbursements or subsidies, which is very harmful to people," says Nicholas Rajacich, MD, an orthopedic surgeon at MultiCare Mary Bridge Children's Hospital and former chair of WAMPAC's board of directors. "The attacks on science are almost too hard to believe."
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Yet in many ways physicians are more likely to feel the decisions made at the state level than at the federal level. "The important work at the federal level impacts insurance, Medicare, Medicaid, and vaccines," says Dr. Schlicher. "The day-to-day things that impact delivery of care are going to be done at the state level." Indeed, from a practice perspective, state regulations have far greater impact on physicians. "At the state level, the laws are really what regulate licensure and scope of practice," says Dr. Peterson.
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By contrast, the sheer volume of interest groups in Washington, D.C., makes it much harder to be heard. Moreover, representatives in particular are trapped in a perennial fundraising loop, which affects their stance on issues.
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"Votes get determined not just from how much they hear from citizens but how much they hear from lobbyist groups," says Dr. Peterson, who has also served on the board of the American Medical Association's political action committee, AMPAC. "Legislators weigh all the opinions and determine how it will affect their potential vote in the primary and general elections. It's purely pragmatic."
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State legislators aren't under nearly the same amount of pressure. As a result, "we can be far more effective advocating for things at the state level than at the federal level," says Dr. Rajacich.
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In addition, says Dr. Schlicher, health care isn't under the same intense spotlight at the state level as it is at the federal level. "The lack of attention on it allows for a little more collegiality than you see at the federal level," he says. "There aren't as many people trying to make the 5 o'clock news with a one-line zinger."
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Campaign contributions from entities like WAMPAC help physicians get to the table and be heard. "We're not talking about huge contributions, but just enough to let the person know that there is a large group of physicians who have concerns about patient issues and are willing to support the campaign to get their attention," says Dr. Peterson.
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While some may worry about the influence money has on politics, for better or worse the reality is that campaign contributions are a language that politicians understand. "The political process is messy," admits Dr. Rajacich. "But we should participate because we have the ability to influence what happens."
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"Frankly, it takes money to engage in this game," agrees Katina Rue, DO, long-term care medical director at Avalon Garden Village in Yakima and hospitalist at Othello Community Hospital, as well as past chair of WAMPAC's board of directors. "We have to have the influence we need by donating to campaigns and starting those connections with candidates."
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The good news, says Dr. Rue, is that candidates are open to the conversation. "As candidates, they want to meet with us," she says. "It's insightful to ask a candidate for their position before they are elected. I think being able to meet with candidates and see whose values align with the values of science and evidence-based practice is very important."
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Dr. Peterson stresses that WAMPAC's sole focus in building relationships is on health care. "Sometimes you have to overlook an issue you have strong views about because it doesn't align with someone 100%," she says. "It's not the political party or how they voted on a budget bill or even some controversial issue that we would personally oppose, but more about how they will listen to the house of medicine."
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<h3>A never-ending campaign</h3>
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While campaigns are a vehicle for establishing relationships, the work doesn't end there. Continuing to maintain those relationships is important to making sure that physicians' concerns are top of mind with legislators.
"I do feel that having this connection with them through the political arm allows us to continue relationships back home in the district," says Dr. Rue.
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At a time when so much of medicine is under question, physicians themselves continue to be highly regarded. That means they can make a difference in conversations with legislators. "Those individual relationships are even more important as society doubts more and more institutions," says Dr. Schlicher. "Of all the people who are going to be involved in advocacy, those in the practice of medicine are still the most trusted. It’s ever more important that you are in the conversation and part of the solution-making."
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Physician participation in political activities sends a clear message to politicians. "Legislative days are very important, because you realize that they have to be responsive to their constituents," says Dr. Peterson. "Involvement is the best way to get to know your legislators and know the issues before them. You have to be involved or the issues that are important to patients will be ignored."
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Indeed, says Dr. Peterson, physicians overwhelmingly find participation rewarding. "Every time I see a new person get involved and sit down with a legislator to explain something, almost without fail they get good feedback," she says. "They can't go back to an uninvolved state."
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However, says Dr. Rue, "Legislative day isn't enough. We need to remain at the table. WAMPAC is one mechanism to do that. The more members and donors we have to our PAC, the more clout we will have with candidates and with the legislators after they are elected."
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<p>
WAMPAC provides its political expertise to all WSMA members as a benefit of their membership in the WSMA and to encourage greater awareness and involvement in the PAC. In general and midterm election years, WAMPAC publishes a legislator report card mailed to WSMA members in advance of the elections as part of WSMA's Legislative Report. WAMPAC also provides WSMA members regular election updates and analysis in the Advocacy Report newsletter. For those interested in diving deeper into state politics, the Diamond Club offers opportunities for more direct interaction with campaigns, including physician-hosted fundraisers. Past fundraisers have included Rep. Schrier as well as candidates for governor and insurance commissioner.
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"I'm a long-time Diamond Club member, and even as I'm getting to the end of my career, it's important to support that work,†says Dr. Rajacich. However, what is important is membership at any level, he says. "I would like to see a large percentage of members of WSMA join WAMPAC. Physicians need us to advocate for what we do and what our patients need."
Engaging with the system may even mean considering running for office. Each year, the AMA holds an AMPAC Candidate Workshop on how to run a successful campaign. The presence of physicians in legislative bodies is important to making sure that physician issues are heard. Dr. Schrier, whom WAMPAC has supported since she first ran in 2018, has been instrumental in representing medicine during her time in Congress and offers insight into why physician representation in government matters. "Doctors are uniquely equipped to be public servants because of the personal relationships and trust we have forged with our patients and the communities we live in," she says.
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"Doctors work with our patients as members of Congress should work with the constituents they serve—we don't know their politics, but we are there to find common ground to solve the issues they face. At a time of sharp partisanship and a rise in medical disinformation, I believe this has become increasingly important because doctors in Congress are focused on putting politics aside to fight for the greater good."
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Meantime, the midterms are looming. Dr. Rue says she understands that for many physicians, the landscape looks bleak. "Right now, people are frustrated, scared, and feeling despair," she says. "Contributing to WAMPAC is one small actionable step that people can take. If we can say that the vast majority of our members donate to WAMPAC, it will be powerful for candidates to hear that."
</p>
<p>
<em>John Gallagher is a freelance writer specializing in health care.</em>
</p>
<p>
<em>This article was featured in the May/June 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 4/28/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| bipartisan-medicare-physician-payment-legislation-introduced | Bipartisan Medicare Physician Payment Legislation Introduced | Latest_News | Shared_Content/News/advocacy-report/2026/April 17/bipartisan-medicare-physician-payment-legislation-introduced | <div class="col-md-12">
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<h5>Apr. 17, 2026</h5>
<h2>Bipartisan Medicare Physician Payment Legislation Introduced</h2>
<p><em>Take action to support federal legislation to improve Medicare payment</em>
</p>
<p>
The recently introduced Provider Reimbursement Stability Act, H.R. 8163, takes a major step in modernizing Medicare physician payment. Introduced by Rep. Greg Murphy, MD, (R-NC), and Rep. Tom Suozzi (D-NY), the bipartisan bill modernizes key budget neutrality rules, ensuring fairness and predictability for medical practices and stability for physicians and patients.
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According to the American Medical Association, when adjusted for inflation, Medicare reimbursement for physician services has declined 33% from 2001 to 2026. Without capping these damaging cuts to physician Medicare reimbursement and other key reforms, doctors are unable to sustainably run their medical practices and are driven to retire or consider consolidating into larger groups, potentially leading to decreased access for patients in rural and underserved communities.
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H.R. 8163 promotes reimbursement stability and protects physicians by updating the budget neutrality threshold; mandating that the Centers for Medicare and Medicaid Services evaluate the actual base costs for running a medical practice at least every five years; and revising how CMS addresses incorrect billing codes.
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Currently, the budget neutrality threshold dictates that if spending increases exceed $20 million in one area, they must be offset by other costs in health care. The $20 million threshold has remained the same since the early 1990s and has never been adjusted for inflation. H.R. 8163 would modernize this outdated provision, providing a long overdue threshold increase to $54.3 million and indexing it every five years based on the cumulative percentage increase in the Medical Economic Index.
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This bill requires CMS to regularly evaluate medical practice costs (i.e., clinical wage rates, equipment, medical supplies, etc.) to prevent large swings in payment rates. In addition, H.R. 8163 directs CMS to correct major errors in billing code estimates by reviewing actual claims data and making prospective rate adjustments, preventing deep, unnecessary cuts under current budget neutrality guidelines that stem from inaccurate utilization projections.
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Make your voice heard: <a href="https://www.votervoice.net/BroadcastLinks/mh_0pW4jamO3xc7U0ny5NQ">Contact your member of Congress</a> and urge them to support commonsense Medicare payment reforms by cosponsoring H.R. 8163. This bill is a step in the right direction to promote viability of physician practices and patient access to care.
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</div> | 4/17/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| latest-updates-on-wiser-prior-authorization-pilot-program | Latest Updates on WISeR Prior Authorization Pilot Program | Latest_News | Shared_Content/News/advocacy-report/2026/April 17/latest-updates-on-wiser-prior-authorization-pilot-program | <div class="col-md-12">
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<h5>Apr. 17, 2026</h5>
<h2>Latest Updates on WISeR Prior Authorization Pilot Program</h2>
<p><em>Virtix announces Gold Card Program; CMS delays services</em>
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Responding to concerns raised by our members and guided by our extensive policies around prior authorization, the WSMA continues to raise concerns with the Wasteful and Inappropriate Service Reduction Initiative pilot program that launched earlier this year and applies prior authorization requirements for the first time ever to traditional Medicare plans. Read on for the latest on this priority issue for patients and the physician community.
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<strong>Virtix Health announces WISeR Gold Card Exemption Program</strong>
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Virtix Health, in coordination with the Centers for Medicare and Medicaid Services, has announced the upcoming launch of the WISeR Gold Card Exemption Program, set to debut July 6. The program will recognize eligible physicians and suppliers in Washington state who consistently meet Medicare coverage criteria by granting exemptions from prior authorization and prepayment review requirements for WISeR services.
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Physicians achieving gold card status may benefit from streamlined administrative processes and reduced review requirements. A Gold Card Exemption Program <a href="https://virtixhealth.com/wiser_model/gold-carding-program">Fact Sheet</a> is now available through the Virtix Health WISeR Resource Center, and additional program details are available at Virtix Health's <a href="https://virtixhealth.com/wiser_model/gold-carding-program">website</a>.
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<strong>CMS delays implementation of two WISeR Model services</strong>
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CMS has announced a delay in implementing two services under the WISeR Model pilot, according to a <a href="https://public-inspection.federalregister.gov/2026-06616.pdf">notice</a> published in the Federal Register: deep brain stimulation for essential tremor and Parkinson's disease, and percutaneous image-guided lumbar decompression for spinal stenosis. CMS indicated that a new implementation date for these services will be announced in a future Federal Register notice.
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<strong>WSMA advocacy</strong>
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The WSMA continues to <a href="https://takeaction.wsma.org/wp-content/uploads/2026/03/wsma-follow-up-letter-to-cmmi-03262026.pdf">raise concerns</a> with federal policymakers regarding the WISeR Model, citing its impact on patient access to care and practice operations. Physicians have reported increased administrative burden and delays in care delivery associated with prior authorization requirements. The WSMA remains actively engaged with CMS and congressional stakeholders to advocate for refinements that reduce unnecessary barriers and support timely patient care.
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At WSMA's urging, several members of Washington state's congressional delegation signed onto a <a href="https://aboutbgov.com/blkR">letter</a> urging appropriators to block funding for the model.
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<strong>Are you subject to WISeR? Share your experience</strong>
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We strongly encourage impacted practices to share their experiences with WISeR with us—including administrative challenges, access issues, and impacts on patient care (positive or negative). The WSMA is uniquely positioned to serve as a conduit between Washington physicians, members of Congress, Virtix, Noridian, CMS, and the media. Your experience under WISeR is critical to informing ongoing congressional oversight and future CMS decision-making. Please contact WSMA Director of Policy Jeb Shepard at <a href="mailto:jeb@wsma.org">jeb@wsma.org</a> to share your feedback.
</p>
</div> | 4/17/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |