ACP Advocates for Health Care Initiatives at Risk in Federal Budget Resolution

As Congress works toward passing appropriations bills, ACP reminds them to reauthorize and extend telehealth flexibilities and essential programs

Sept. 12, 2025 (ACP) -- As the deadline to fund the federal government for the coming fiscal year approaches, the American College of Physicians is urging members of Congress to take action before several key initiatives -- including Medicare telehealth flexibilities and essential workforce programs -- face disruption due to lack of funding.

“Congress is currently working on passing all 12 appropriations bills for the 2026 fiscal year, but they are nowhere near close to finishing that work as not all the bills have been fully drafted,” said Jared Frost, ACP manager for legislative affairs and ACP Services PAC. “More importantly, there has not been a bipartisan agreement about the funding levels overall.”

ACP is urging its members to contact their lawmakers about these topics on the Advocates in Internal Medicine Network.

The stakes are high. If Congress fails to act by Oct. 1, the beginning of the 2026 fiscal year, a government shutdown would halt all nonessential federal functions. While programs like Medicare, Medicaid and Social Security would continue initially, “an extended shutdown could eventually affect the processing of Medicare payments,” Frost warned.

The ripple effects would extend far beyond federal agencies. “The health care system will get impacted at different levels, with state and local governments that rely on federal funding not receiving those resources, including possibly academic institutions, hospitals and other nongovernmental organizations,” he said.

The fight over appropriations in Congress may sound familiar to those who have been following the news over the last few months. Indeed, Congress approved appropriations bills via a continuing resolution in March. But that bill only extended funding for the 2025 fiscal year, which expires on Sept. 30.

As Congress figures out its spending priorities, the Medicare telehealth flexibilities that have transformed health care delivery since the COVID-19 pandemic are especially endangered. “Congress has extended flexibilities for physicians to furnish services by telehealth to patients who are enrolled in Medicare,” Frost explained. “ACP has strongly advocated for extending those flexibilities on a permanent basis.”

However, fiscal constraints have limited previous extensions. “Due to cost, Congress usually has extended these flexibilities for only two years at most, and many times just for a few weeks or months because of the use of short-term stopgap extensions through continuing resolutions,” Frost observed.

The telehealth flexibilities are “crucial for patient care to extend the lifting of geographic site restrictions so telehealth services can continue to be provided to those in both rural and urban areas,” he said. “It's also important to allow for audio-only telehealth services, which are critical to patient care. We have seen how telehealth services can help to increase access to necessary health care for patients.”

ACP is also concerned about the fate of two cornerstone workforce development programs. “ACP has urged Congress to include in their spending legislation a long-term reauthorization of funding for programs that are essential to primary care and the health workforce, including the National Health Service Corps and the Teaching Health Center Graduate Medical Education (THCGME) programs, which are now only funded until Sept. 30,” Frost said.

These programs help train primary care physicians and place them in underserved communities at a critical time when health care workforce shortages persist nationwide.

With a full appropriations package unlikely before the Oct. 1 deadline, Congress will probably resort to yet another continuing resolution -- a temporary funding measure, Frost said.

However, even this stopgap solution faces obstacles. “Right now, the House, the Senate and the administration all want a continuing resolution but cannot even agree on how long it should be,” Frost explained. “Reports indicate possibly into November or December, but the administration reportedly wants a continuing resolution to go past the end of the year into 2026.”

Adding to the complexity, “there's the question if congressional Democrats will even support a continuing resolution because of the administration's appropriations hijinks with impoundment (not spending appropriations as allocated) and recissions (not spending appropriations at all),” he noted. “Democrats are seeking assurances that the administration would actually spend the federal funds as passed by Congress.”

Even if a continuing resolution passes, it would probably provide only temporary relief. “It is likely that extensions for telehealth will only be for the duration of the continuing resolution, rather than at least the two years needed for there to be stability and certainty moving forward,” Frost warned.

This short-term approach creates ongoing uncertainty for physicians and clinicians and institutions trying to plan for the future. “ACP believes a long-term extension will allow Congress time to hopefully enact permanent extensions,” Frost said.

ACP's advocacy is becoming more intensive. In a joint letter, ACP joined the American Association of Teaching Health Centers, American Association of Colleges of Osteopathic Medicine, American Osteopathic Association, National Association of Community Health Centers, Council of Academic Family Medicine and Society of General Internal Medicine in urging the Senate Committee on Health, Education, Labor and Pensions to prioritize considering multiyear authorization of the THCGME program.

“At our Hill meetings and PAC events, ACP lobbyists have been clear that these are priorities and the clock is ticking,” Frost stated. “ACP has also made clear that we need more than just another stopgap extension. At least two years is necessary to provide the needed stability and certainty for these programs.”

Back to the September 12, 2025 issue of ACP Advocate