AAFP warns of ‘dangerous precedent’ in health care policy

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The American Academy of Family Physicians (AAFP) is warning that recent policies emerging from state legislatures and the federal government are putting the practice of medicine at risk.

In an April 24 statement, the AAFP said it is “increasingly concerned with efforts at the state and federal level to interfere with the patient-physician relationship and encroach on the autonomy of physicians.

“The AAFP stands firmly against any policies that criminalize physicians and medical care, threaten the patient-physician relationship and inhibit the delivery of medical care and education,” the organization said. “It is a dangerous precedent to allow individuals without medical training to make decisions affecting clinical and medical practice.”

The statement comes amid a wave of policy activity during the first 100 days of President Donald J. Trump’s second term in office.

President Donald J. Trump © Courtesy of the Library of Congress Prints and Photographs Division

Workforce cuts and restructuring

Robert F. Kennedy Jr. © U.S. Department of Health and Human Services

Under the leadership of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., the department has undergone substantial restructuring. A new entity, the Administration for a Healthy America, has been established, absorbing several existing HHS offices and programs.​

With this reorganization comes the loss of approximately 20,000 employees through layoffs and voluntary departures. The changes have disrupted operations at agencies under HHS, including the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH).​

Funding for numerous NIH research grants has been frozen or rescinded, particularly those related to chronic disease and LGBTQ+ health. Internal CDC materials have been revised to remove references to terms associated with diversity, equity, and inclusion (DEI) initiatives.

Reproductive and gender-affirming care

The administration's actions on reproductive health and gender-affirming care have raised concerns among physicians and health organizations.​

Title X funding has been frozen for clinics serving low-income patients, and the administration reinstated the Mexico City Policy, which restricts U.S. foreign aid to organizations involved in abortion services. Additionally, President Trump signed Executive Order 14182, enforcing the Hyde Amendment and revoking prior orders that expanded access to reproductive health care.

At the state level, physicians in several states could face charges for providing gender-affirming care to minors, and others could lose their licenses or face professional sanctions for offering medically recognized treatments.

Drug pricing, tariffs and Medicaid

The administration has unveiled a drug pricing executive order that expands Medicare negotiations, aims to address anticompetitive practices and promotes price transparency. However, it comes alongside other economic policies that could raise costs for patients.

Trump has initiated a Commerce Department investigation into pharmaceutical imports under Section 232, raising the possibility of tariffs on medications and raw materials. The move, framed as a measure of national security, has concerned health systems and supply chain experts.

“There are definitely still some outstanding operational and technical questions as it relates to how manufacturers will be making those [maximum fair prices] available to dispensing entities,” said Ashley Flint, a principal in health policy and strategy at Avalere Health, during a panel at Asembia’s AXS25 Summit. Flint warned that changes could lead to delays in drug availability and reimbursement gaps that affect patient access.

Congress is also advancing a major budget reconciliation package that includes an estimated $1.5 trillion in spending cuts, significant Medicaid reforms and extensions of Trump-era tax policies. Policy analysts say cuts to Medicaid could affect hospitals, physicians and state budgets alike.

Medical groups push back

The AAFP is not alone in its concern. The American Medical Association (AMA), the American College of Physicians (ACP) and the American College of Obstetricians and Gynecologists (ACOG) have issued statements condemning recent laws and regulations that insert politics into clinical care.

Georges Benjamin, executive director of the American Public Health Association (APHA), described the administration’s early months as “a chaotic, incompetent mess, from a health perspective.”

Public sentiment is divided. A Harvard/de Beaumont Foundation poll found that 48% of U.S. adults believe the CDC will function better under Trump, while 52% believe it will get worse.

A ‘dangerous precedent’

While the AAFP’s statement does not name specific laws or individuals, its timing makes clear the group’s unease with the White House’s direction on health policy.

“Physicians must be able to practice evidence-based medicine in consultation with the patients they serve,” the statement read. “And medical educators must be able to prepare the next generation of physicians without interference.”

As the administration moves past its first 100 days, the medical community is bracing for further upheaval — and warning that the stakes include not only professional autonomy, but the future of patient care itself.