SGIM Advocacy Agenda

About The agenda

SGIM focuses on three policy areas – clinical practice, education, and research – and on cross-cutting federal policies important to SGIM members and their patients, including those that have broad implications for general internal medicine.

The 2026-2027 Health Policy Agenda defines the issues on which the Health Policy Committee (HPC), its staff, and consultants will work for the next year. The language in this agenda is intentionally broad to give the Committee flexibility to adapt and consider focusing on new issues that may arise over the year.

Specific policy and advocacy issues will continue to be addressed in the regular meetings of each of the three Subcommittees (Clinical Practice, Education, and Research) and the HPC Executive Committee. In addition, the HPC and our consultants at CRD work with SGIM leadership almost daily when new health policy issues are brought to our attention. In the next year, SGIM will need to coordinate its policy work with the Society’s new Task Force on the Future of Academic Primary Care Internal Medicine.

Whenever possible, SGIM will collaborate with organizations with similar interests, whether physician groups, organizations representing patients, or other relevant entities. Special attention will be paid to communicating SGIM’s positions to its membership and policymakers.

SGIM meeting attendees seated at a round table, engaged in discussions.

Note: In the policy topics listed below, “Active Advocacy” refers to those highest priority issues in which SGIM members, staff, and consultants will be heavily involved. “Coalition Advocacy” refers to other high-priority issues on which SGIM’s consultants and leadership will work collaboratively with other stakeholder organizations in Washington and beyond to advance SGIM’s positions. “Monitoring” refers to those issues on which SGIM’s consultants will track and advise, but will not actively promote a position. SGIM members, of course, are free to advocate in their personal capacity on any of these or other issues as they see fit.

Clinical practice

SGIM will continue its advocacy efforts to support the delivery of high-quality primary care and cognitive services that improve patient outcomes by emphasizing how comprehensive, longitudinal primary care improves health, provides first-contact access, coordinates care, manages complexity and chronic illness, and helps patients navigate the health system.

Active Advocacy

Advocate for reforms to support a robust primary care system to ensure Americans have appropriate access to comprehensive preventive and primary care services designed to reduce the burden of chronic diseases and keep Americans healthy. This includes advocacy to implement a hybrid payment system that: (1) Invests in primary care capacity by supporting personalized, team-based care and paying for services tailored to the needs of the patient and the community; (2) Reduces or simplifies the burdensome documentation requirements associated with many service codes, which add to systemic costs and consume clinical time that could be better spent with patients; and (3) Allows for additional, higher payment tiers based on the scope of services. Additionally, SGIM will advocate for payers to align their hybrid payment policies as this model is adopted more widely.
Support the authorization of a technical advisory committee (TAC) to ensure that evaluation and management services reflect the full range of care provided during primary care and cognitive office visits, including those delivered remotely.
Advocate for policies to support a robust Medicaid program with comprehensive benefits and to mitigate coverage losses from the One Big Beautiful Bill Act. This includes policies to support improved efficiency of the program at the federal and state levels.
Advocate for policies that support appropriate access to care, diagnostics, and therapies by reducing the burden of prior authorization and other utilization management

Coalition Advocacy

Advocate to ensure that all patients have access to affordable high-quality health care services through the Affordable Care Act, Medicare – both traditional and Medicare Advantage plans – and other coverage mechanisms.
Support steps being taken to address substance use disorder and addiction, including measures to ensure patients have access to the necessary services to address their addiction and steps to address the disparities seen in the populations with the highest rates of substance use disorder and addiction.
Support the permanent extension of telehealth flexibilities, including the elimination of originating site and geographic restrictions and coverage of audio-only services.
Promote policies that support appropriate care and access for women, LGBTQ+, people living with HIV, and immigrant communities.
Promote policies that support the use of AI to facilitate care delivery and reduce burden while protecting patients’ privacy, access, and choice.
With over half of Medicare beneficiaries enrolled in Medicare Advantage programs, ensure that the programs provide robust coverage to primary care and other medically necessary services without burdensome requirements, like prior authorization, that delay care.

Monitoring

Monitor legislative and regulatory policies on drug pricing to ensure that Americans have access to affordable prescription drugs.
Monitor policies related to consolidation in the health care system to ensure that patients continue to receive high-quality, patient-centered care. Policies should preserve a diverse and competitive health care system and address consolidation that increases costs, reduces patient choice or access, or undermines physician autonomy.

EDUCATION

In fulfilling their commitment to promoting public health and improving health care, SGIM members lead the education of medical students, residents, and fellows as well as faculty at academic centers, teaching hospitals, and in the community. They are leaders in developing and evaluating innovations in medical education to prepare tomorrow's clinicians to deliver the highest quality evidence-based and cost-effective clinical care. To support these efforts, SGIM will continue to focus on:

Active Advocacy

Ensure that the Department of Health and Human Services (HHS) continues to support workforce programs to support the growth of a well-trained primary care workforce to help Americans prevent and treat the chronic conditions burdening their health as the administration reorganizes the department. This includes reauthorization of Title VII programs and ensuring HRSA spends appropriated funds as Congress intends.
Advocate for robust investment and comprehensive reform in Medicare graduate medical education (GME), including expanding the number of GME slots available for primary care and other shortage specialties and establishing a transparent, outcomes-focused payment structure that holds institutions accountable and ensures an appropriately distributed and well-trained physician workforce equipped to meet the nation’s health care needs.

Coalition Advocacy

Support robust and sustainable funding for physician training programs, including the Teaching Health Center Graduate Medical Education (THCGME) program, the National Health Service Corps, and Title VII programs such as Centers of Excellence, Health Careers Opportunity Program, Primary Care Training and Enhancement, Area Health Education Centers, and mental and behavioral health training programs.
Support the collection, analysis, and dissemination of information relating to the health care workforce supply and demand; the development of recommendations for eliminating the barriers to recruitment and retention in primary care; policies that foster innovative education and training programs; improved mechanisms for financing education and training for careers in primary care; and research on how the growth of private equity ownership of health care facilities and provider groups may be affecting workforce stability and access to high-quality care.
Support legislation and policies regarding streamlining visa application processes for medical residents and physicians, to protect the role that International Medical Graduate (IMG) physicians with J-1, H-1B, and O-1 visas play in the provision of healthcare in the US, including the essential services they provide in rural and medically underserved areas.

Monitoring

Monitor workforce policy developments in Congress and the administration and act on opportunities for SGIM member engagement and representation.
Monitor legislation and/or administrative actions that may impact education and training future physicians at VA facilities, including changes made to the Veterans Community Care Program or changes in the number of GME positions the VA currently funds.
Protect the integrity and inclusivity of medical education accreditation standards and ensure access to federal financial aid, including student loans, for students attending accredited institutions that prepare a well-trained primary care physician workforce to meet the needs of all communities

RESEARCH

SGIM members are national and international leaders in a wide range of research, including the many subfields that fall within the broad category of health services and primary care research. The need for robust and sustained funding for research remains the Society’s priority interest in this domain. The specifics are as follows:

Active Advocacy

Protect sustained federal investment in biomedical, clinical, and health services research and preserve critical research functions across HHS. Support a federal research enterprise in which congressionally appropriated funds are spent consistent with congressional intent and grantmaking processes uphold scientific integrity, rigorous peer review, and transparency.
Restore the functions of the Agency for Healthcare Research and Quality related to extramural research funding, evidence synthesis, data infrastructure, and research training. Strengthen federal investment in health services and primary care research, including the restoration of federal funding for research that has been prematurely or abruptly terminated. Advocate for research into payment models and primary care that ensures that the benefits of science extend to all health systems and populations.
Protect and support robust funding for the National Institutes of Health, its institutes and centers, and programs of particular importance to general internal medicine, including the National Institute on Minority Health and Health Disparities, the National Center for Advancing Translational Sciences (including the Clinical and Translational Science Awards), and programs that develop and sustain the medical research workforce.

Coalition Advocacy

Support the highest possible overall funding levels for research at the Department of Veterans Affairs (VA) and Patient-Centered Outcomes Research Institute (PCORI), including preventing recission of the PCOR Trust Fund.
Coordinate with other leading organizations to advocate for the restoration of abruptly halted AHRQ grants to protect ongoing research and ensure federal investments are not wasted.
Ensure that policies support research training programs across the federal government.
Preserve the importance of peer review in the grant review process at NIH and advocate for transparency in determination of grants awards.

Monitoring

Support research structures that enable SGIM members to conduct high-quality research unencumbered by restrictive policies or censorship on topics, like gun violence prevention research and gender affirming care, and support SGIM’s priorities of improving health care delivery and promoting health equity.
Support legislation and regulatory actions aimed at increasing clinical trials diversity with a particular focus to maximize representation of trial populations especially at smaller research institutions.

Every Member an advocate: Championing Comprehensive Primary Care

Advocate Nationally

Join the SGIM Health Policy Committee and speak out for practices and policies that further the mission of primary care and general internal medicine.

Learn More