Physician groups warn of bad effects on health care as Senate takes up Big Beautiful Bill

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As the Senate takes up consideration of the One Big Beautiful Bill Act national spending plan, some of the nation’s leading medical groups are repeating their concerns about potential effects on health care.

For weeks, lawmakers, medical organizations and patient advocates have argued about what the Big Beautiful Bill would mean through potential cuts to Medicaid, and more.

The American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), the American College of Physicians (ACP), the American Osteopathic Association (AOA) and the American Psychiatric Association (APA) reiterated their concerns in a joint statement warning of dire effects from the legislation.

“Our organizations, representing more than 600,000 physicians, share an unwavering belief that everyone deserves access to quality, affordable health care,” they said. “As the Senate considers the House-passed budget reconciliation package, we urge lawmakers to protect patients’ access to affordable health insurance, maintain full access to loan borrowing and student loan forgiveness programs to ensure a path for aspiring physicians, and meaningfully reform Medicare physician payment to safeguard access to care in underserved rural and urban communities. Failing to do so will have real and long-lasting consequences for patients, physicians, and the stability of our health care system.”

Medicaid

The physicians are concerned about cuts to Medicaid and to tax credits that allow people to buy health insurance through the Affordable Care Act online marketplaces.

“Medicaid is a lifeline for children, families, pregnant and postpartum people, individuals with disabilities, and those struggling to make ends meet,” the statement said. “If the Senate allows the House’s proposed work reporting requirements, eligibility restrictions, and financial barriers to become law, millions of people could lose their health care coverage — risking their health, financial security, and in many cases, their lives. The expiration of enhanced Affordable Care Act tax credits would only exacerbate these disruptions, leaving more people without the care they need.”

Student debt relief

Medical students graduate with knowledge to heal patients — and often with mountain of debt. Meanwhile, the United States has a shortage of doctors, especially in underserved and rural areas, with projections that situation will get worse in coming years.

The Big Beautiful Bill could make that situation worse yet, the medical groups said.

“Our nation is already grappling with a physician shortage, especially in underserved and rural areas,” the joint statement said. “Limiting access to federal student loans will put medical school out of reach for the aspiring physicians of tomorrow, and weakening student loan forgiveness programs would make it harder to recruit and retain physicians in communities that need them most. Without loan forgiveness programs, many medical graduates will face insurmountable debt, pushing them away from careers in medicine — especially primary care — at a time when they are desperately needed.

Physician pay

Medicare payment for physicians does not keep up with inflation. For years doctors have been requesting more money and a recalculation of how to determine what Medicare pays.

That needs to change because physicians are having difficulty staying in business, which in turn hurts patient health, the doctors’ groups said.

“Instability and cuts year after year are forcing practices — especially small, independent, and rural ones — to scale back services or close altogether,” the joint statement said. “Without comprehensive reform, patients will lose trusted physicians, and entire communities may be left without access to care.”

‘Chart a better course’

The organizations concluded with a request.

“We call on the Senate to chart a better course,” they said. “The health of our patients, the strength of our physician workforce and the future of our health care system depend on it. We stand ready to work with lawmakers to ensure health care remains accessible to all who need it.”

The House of Representatives passed the bill on May 27.

On June 2, news outlets reported on legislators’ comments from the last few days, including on Sunday talk shows. There was plenty of speculation about how the Senate could handle procedures for debating and voting on the bill, who would agree or dissent with certain provisions, and how much it could change from the version adopted in the House, and whether the bill would be passed by July 4 or afterward.

CBS News reported House Speaker Mike Johnson, a Louisiana Republican, recently ventured to the other side of the U.S. Capitol to remind Republican senators "that we are one team" and pleaded with them to keep the bill substantially intact. Senate Majority Leader John Thune, a South Dakota Republican, acknowledged that balance, but told reporters "the Senate will have its imprint" on the bill. He can afford three "no" votes from Republicans if all Democrats vote to block its passage in the Senate, and there are no absences.

It appeared Medicaid and health care provisions could be sticking points. Roll Call reported three Republicans, Sen. Josh Hawley of Missouri, Sen. Susan Collins of Maine, and Sen. Lisa Murkowski of Alaska had reservations due to the bill barring states from enacting new provider taxes that states used to finance Medicaid. Those states have large rural populations, and the American Hospital Association has argued Medicaid cuts will be financially devastating to rural hospitals.