H.R. 1 is now law, and it will affect family physicians and their communities in numerous ways. In this episode, AAFP Government Relations Vice President David Tully talks with members of the AAFP's GR team about H.R. 1's impacts on primary care. You'll also hear about what happens next, and how AAFP members can get involved, starting with advocacy this month during Congress' August recess.

Topics By Timestamp:

00:00 Introduction

01:02 Team introductions

01:30 Medicaid barriers in H.R. 1

• With some exemptions, individuals ages 19-64 in expansion states will have to document that they work or volunteer at least 80 hours a month to be eligible for Medicaid; this is required by 2027, but states can implement sooner.

• States must conduct eligibility redeterminations at least every six months for adults enrolled in Medicaid expansion;

• Retroactive coverage will be limited to one month prior to application for expansion enrollees and two months prior to application for traditional enrollees.

06:52: Provider taxes

08:40: Wins in H.R. 1

• A proposal to exclude medical and dental residents from participating in the Public Service Loan Forgiveness Program (PLSF) program was removed from the final version of the bill.

• A ban on Medicaid funds being used to pay for gender-affirming care services for any individuals also was removed.

• The law will allow people with health savings accounts to use those funds to pay for direct primary care (DPC) arrangements, beginning Jan. 1. The AAFP had long called for this change, in line with its DPC advocacy.

10:45: Nutrition impacts

• Supplemental Nutrition Assistance Program (SNAP) barriers in H.R. 1:

• • No re-evaluation of SNAP benefits beyond inflation,

• • SNAP benefits will not be updated based on future changes to nutritional guidelines and

• • State-federal cost sharing for states with payment error rates over 6% (about 47 states).

12:50: Workforce impacts

• More about the PSLF win (following the AAFP's 2025 Family Medicine Advocacy Summit)

• Elimination of GRAD Plus

• Caps on student loans

17:09: Tax policy win for independent practices: 20% pass-through deduction

20:03: Medicare physician payment relief

22:59: What's next in Congress

29:13: Congress' August recess: It's easy for AAFP members to advocate this month.

32:40: Conclusion

Additional Resources

• AAFP Advocacy Ambassadors

• FFFM podcast: Inside the 2025 Family Medicine Advocacy Summit

• AAFP Voices: Make August Count for Family Medicine Advocacy Where You Are. Here's How

• AAFP News: AAFP summary of 2026 proposed MPFS outlines payment boost, other potential wins

• AAFP News: Against AAFP objections, new CMS coverage rule will hinder care access

• AAFP News: Threatened loan forgiveness program is 'a lifeline' to this FP—and her patients

• AAFP News: Academy Pushes for Tax Policy Favoring FPs

• AAFP News: AAFP urges Senate to stave off 'tsunami'

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