VIP Insider: May 2025

Welcome to the late spring edition of the AMA's Very Influential Physician (VIP) Insider. Read on for details about these topics:

Urge your Senators to support S. 1640
Don't overthink the Senate map
The public’s early assessment of 2026
Campaign School returns September 11-14 – register now!

Urge your Senators to support S. 1640
Due to Congressional inaction in 2024, physicians received yet another 2.83% payment cut starting January 1, 2025, marking the fifth consecutive year that Medicare physician payment has been cut. In fact, since 2001, when adjusted for inflation, Medicare physician payments have decreased by 33%.

Please contact your Senators today and urge them to cosponsor the "Medicare Patient Access and Practice Stabilization Act" (S. 1640) today.

This is simply not sustainable – many physician practices were already hanging on by a thread and this latest round of cuts will only worsen the situation, forcing many struggling practices to make the hard decision of operating at a loss or closing their doors forever.

America's physicians and patients deserve better - Recently, Sen. Roger Marshall, MD (R-KS) introduced the "Medicare Patient Access and Practice Stabilization Act" (S. 1640), companion legislation to H.R. 879, which was introduced earlier this year by Reps. Greg Murphy, MD (R-NC) and Jimmy Panetta (D-CA).

This legislation, if passed, would temporarily reverse the damaging 2.83% cut and provide a much-needed 2% positive payment update, which is an increase equivalent to roughly half of the Medicare Economic Index (MEI) for 2025, helping to stabilize physician practices and protect patients' access to care.

Please join the thousands of physicians from across the country who have already taken action by contacting your Senators and urge them to cosponsor the "Medicare Patient Access and Practice Stabilization Act" (S. 1640) today!

The Medicare physician payment model is hopelessly broken, and these yearly cuts are having a negative impact on physician practices while leaving patients' access to care at risk. It's time Congress finally did something about it!

America's patients are counting on Congress to provide this much-needed relief and work toward achieving long-term Medicare physician payment reform.

Don't overthink the Senate map
By Kirk A. Bado of the National Journal

After two big names recently passed on Senate bids—former Gov. Chris Sununu (R) in New Hampshire and Gov. Brian Kemp (R) in Georgia—some analysts were already writing obituaries for the GOP majority.

Democrats spiked the football, growing bullish that backlash to the Trump administration, coupled with Republican recruitment stumbles in two marquee races, will deliver them the majority next year.

But the math is more complicated for Democrats and any talk of a potential flip is premature.

Even though Senate Republicans underperformed in 2024—they flipped just one of five battleground Senate races while President Trump swept all of them—Democrats are still in a deep hole. They need to net four seats to get a 51-49 majority and serve as a check on Trump's final two years in office.

To flip the Senate this cycle, everything needs to go right for Democrats.

They need to defend 11 seats, including the only two races The Cook Political Report with Amy Walter ranks as Toss-Up: Georgia and the open seat in Michigan. Even without Kemp in the race, Sen. Jon Ossoff (D-GA) is still the most vulnerable senator by any metric.
Democrats' top offensive targets are Maine and North Carolina. Democrats' easiest path to flipping Maine is if Sen. Susan Collins (R-ME) retires. If not, Gov. Janet Mills (D) could make the race competitive, but nothing is guaranteed with Collins on the ticket. In North Carolina, Democrats are waiting for former Gov. Roy Cooper's (D) summertime decision on whether he'll run. Sen. Thom Tillis (R) is fending off a suite of MAGA-aligned primary challengers. If he loses renomination and Cooper jumps in the race, Democrats would be slightly favored.
Democrats could have a path in Texas if state Attorney General Ken Paxton (R), a polarizing ally of Trump who was nearly impeached two years ago, beats Sen. John Cornyn (R) in a primary. They don't have a candidate yet, but 2024 nominee Colin Allred (D) could launch a comeback campaign if the opportunity presents itself.

Even if all the dominos fall in Maine, North Carolina, and Texas, and they defend every state they hold, that's only a net of three seats. This would make a 50-50 Senate, with Vice President JD Vance as a tiebreaker.

To secure that critical fourth seat, Democrats need to expand the map into states where they've bled support in recent elections. Top of the expanded map is Alaska, should former Rep. Mary Peltola (D-AK) challenge Sen. Dan Sullivan (R). Peltola, who flipped the state's lone House seat for the first time in decades four years ago, is also considering a run for governor. Democrats are monitoring races in Kansas, Iowa, and Nebraska as well.

Outside those rural states, Democrats could get competitive in the pair of special elections in Florida and Ohio with the right candidates and favorable political winds. Again, that's a big ask.

DSCC Chair Kirsten Gillibrand said in November it would take at “least two cycles” to win back the majority. Even with all the recent developments, that's still the most likely case.

The public’s early assessment of 2026

By Debra Leiter, Mary Stegmaier, and Michael S. Lewis-Black of Sabato’s Crystal Ball

Midterm elections to the United States Congress are often viewed as referenda on the performance of the president’s party, with voters rewarding or punishing on key issues accordingly. More specifically, the “iron law” in these contests, as noted by Charles Tien and Michael Lewis-Beck, “foretells the ruling party would experience a net loss” of seats. Since the end of World War II, presidential party seat loss has been common in midterms, although the loss happens more consistently in the House than in the Senate. Both voters and political strategists thus often view these elections not as a question of who will win, but of just how big the losses for the incumbent party will be.

The current partisan composition of the U.S. government, with a Republican president and slim Republican majorities in both the House and Senate, point to the near certainty of midterm congressional loss for the Republicans in 2026. Indeed, two recent publications in the Crystal Ball point to the Democrats retaking the House, according to the House race ratings and the generic ballot. The practical question, in terms of the transfer of political power, becomes “Will the incumbent party lose majority control of the chambers?” Herein we examine how Americans are currently answering that question for the House and the Senate in national scientific public opinion surveys recently fielded by Verasight in April 2025. The findings suggest that voters have clear and consistent opinions about which party will control Congress. Moreover, the predictions, as they stand, indicate that this “iron law” of incumbent party loss might be broken, with the Republicans keeping control of one, if not both, chambers. Below, we unfold the evidence, beginning with the quality of the survey, then go on to consider majority forecasts for the House and the Senate. Finally, we draw conclusions about the degree of accuracy these citizen forecasts display.

In its annual Midwest Political Science Omnibus Survey, fielded from April 9-15, 2025, the polling firm Verasight conducted three sample modules of high scientific quality, each with 1,000 U.S. adult respondents. Respondents came from the Verasight Community, individuals randomly recruited by addresses, text messages, and online, subject to multi-step authentication. Further, the data were weighted to match key socio-demographics, including age, race/ethnicity, sex, income, education, region, metropolitan status, and partisanship. The margin of error, employing the classical random sampling formula, is +/- 3.5% for the Elections module, which we utilized for the tables and results below.

The central survey questions we analyze ask respondents to predict which party will achieve a majority in the House and in the Senate. The specific wording, for the House, is as follows:

“Thinking about the midterm elections in 2026, which party do you think will win control of the U.S. House of Representatives?” (Response options: Democrats will win a large majority, Democrats will win a slim majority, Republicans will win a slim majority, Republicans will win a large majority). The same question was asked for the Senate. Continue reading

Campaign School returns September 11-14 – register now!
AMPAC is excited to announce that the 2025 Campaign School will be returning September 11-14 at the AMA offices in Washington, DC!

Running an effective campaign can be the difference between winning and losing a race. That’s why the Campaign School is designed to give you the skills and strategic approach you will need on the campaign trail. Our team of political experts will teach you everything you need to know to run a successful campaign. Under the direction of our lead trainers, participants will be broken into campaign staff teams to run a simulated congressional campaign using what they’ve learned during group sessions on strategy, vote targeting, social media, advertising and more.

Attendees may include physicians, spouses of physicians, residents and medical students and state medical society staff interested in becoming more involved in politics. Participants range from those attracted to grassroots efforts to those considering becoming a candidate for public office. No matter where you are in the process, you will develop a new understanding of how campaigns are run. As a graduate of the AMPAC program, candidates will rely on you to give them advice on strategy, message, and campaign plans.

Please note the following:

The Candidate Workshop is open to AMA physician members, member spouses, residents, medical students and state medical society staff.
Registration fee is $350 for AMA members and member spouses/$1000 for non-AMA members. This fee is waived for AMA residents and students; however, space is limited and the AMPAC Board will review and select four participants from the pool of qualified resident and student applicants.
Faculty, materials, and all meals during the meeting are covered by the AMA. Participants are responsible for their registration fee, travel to/from Washington, DC and hotel accommodations (AMPAC staff will provide you with a list of nearby hotels within walking distance of the AMA offices).
Participants will be required to bring a laptop or Wi-Fi enabled tablet with them.

Registration for the 2025 Campaign School is now OPEN. Space is limited and the deadline to register is August 8 (or sooner if maximum capacity is reached).

Be sure to follow all the AMA's Physician Grassroots Network social media accounts for all the latest news on physician advocacy and what you can do to make sure your voice is heard on Capitol Hill.

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