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

• Congress prepares a bipartisan health care package with AMA priorities
• 2026 Candidate Workshop returns to Washington, DC April 17-19 – registration now open!
• The Senate: A couple of rating changes in favor of Democrats, but Republicans still favored overall
• 2026 congressional midterm calendar: when each state is voting

Congress prepares a bipartisan health care package with AMA priorities
Congressional leaders have agreed to a bicameral, bipartisan package of health care proposals that includes parts of the American Medical Association's (AMA) policy agenda. 

"To get the finish line, individual negotiators didn't get everything they wanted, perhaps, yet good policy emerged from the negotiations. These proposals will benefit our patients in their everyday encounters with physicians," said David H. Aizuss, MD, chair of the AMA Board of Trustees. "Whether it's telehealth, or diabetes, or Medicare directories, these policies have real-world, beneficial impacts."

Specifically, the package includes the following provisions that would:  

• Renew Medicare telehealth coverage for two years. Following the disruptive, 43-day lapse during the 2025 government shutdown, this extension helps restore continuity of telehealth services for Medicare patients. The AMA strongly supports this extension and continues to advocate for permanent authorization of Medicare telehealth flexibilities.
• Restore a 3.1% bonus for physicians participating in Medicare alternative payment models that expired in 2024 for one year. These provisions strengthen physician participation in value-based care by restoring meaningful incentives and reducing barriers to entry.
• Adopt AMA-endorsed legislation that expands access to the Medicare Diabetes Prevention Program (MDPP). For the first time, CDC-recognized virtual diabetes prevention programs will be included in the MDPP expanded model on a trial basis from January 1, 2026, through December 31, 2029. This expansion addresses longstanding access barriers created by in-person participation requirements and improves access for Medicare beneficiaries in rural and underserved communities.
• Require Medicare Advantage plans to maintain accurate, regularly updated provider directories and publicly report directory accuracy.
• Extend the Acute Hospital Care at Home waiver for five years, through 2030. The extension preserves a proven, physician-led model that delivers hospital-level care safely in the home, improving outcomes and patient satisfaction.
• Expands the Dr. Lorna Breen Health Care Provider Protection Act for five years, through FY 2030. The legislation continues funding, mandates annual stigma-reduction campaigns and broadens grant eligibility to address administrative burden. The AMA has supported this program since its inception and strongly supports its reauthorization.
• Introduce targeted pharmacy benefit manager (PBM) reforms that enhance transparency, curb abusive Medicare drug rebate practices, and strengthen enforcement against anti-competitive behavior. These provisions represent tangible progress toward lowering prescription drug costs and improving fairness in the drug supply chain for patients and physicians.

"The AMA commends congressional leaders for finding common ground," Dr. Aizuss said. "As physicians, we know that the best results come from focused attention on what is best for patients. That's what happened here."

2026 Candidate Workshop returns to Washington, DC April 17-19 – registration now open!  
Ever wonder how Doctors get elected to Congress or your state legislature? Considering a run for office for yourself? The AMPAC Candidate Workshop will teach you how to run a winning political campaign, just like we taught many of your AMA colleagues over the years. The Candidate Workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office.

We are excited to announce that the 2026 AMPAC Candidate Workshop will be held in-person, April 17-19 at the AMA offices in Washington, DC – registration is now OPEN!

At the Candidate Workshop, Republican and Democratic political veterans work together to give you expert advice about being a successful candidate and how to run a winning campaign. You will learn: the importance of a disciplined campaign plan and message; the secrets of effective fundraising; what kinds of advertising may be right for your campaign; how to work with the media; as well as how to build your campaign team and a successful grassroots organization.

Attendees include physicians, spouses of physicians, residents and medical students and state medical society staff interested in becoming more involved in politics.

Please note the following:

1. The Candidate Workshop is open to AMA physician members, member spouses, residents, medical students and state medical society staff.
2. Registration fee is $250 for AMA Members/spouses and $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.
3. 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 (AMA will provide you with a list of nearby hotels within walking distance of the AMA offices).
4. Participants will be required to bring a laptop or Wi-Fi enabled tablet with them.

Registration for the 2026 AMPAC Candidate Workshop is now OPEN. Space is limited and the deadline to register is March 20 - or sooner if maximum capacity is reached.

For more information please contact: Politicaleducation@ama-assn.org

The Senate: A couple of rating changes in favor of Democrats, but Republicans still favored overall 
By Kyle Kondik

The 2026 midterm may once again be a "Blue Wave," as we saw in 2018, Donald Trump's first midterm as president.

But that environment wasn't enough for Democrats to win the Senate that year, and it may not be in 2026, either.

While Democrats have made progress over the course of the last year in positioning themselves to compete in enough Republican-held seats to win the majority, the GOP nonetheless remains favored to hold that majority.

The basic asset for Republicans, and problem for Democrats, is the structure of the Senate map. With Republicans having knocked out all of the remaining Democrats from states that voted for Donald Trump all three times he was on the ballot—a group of 25 states that accounts for half of all the Senate seats—Democrats either have to start winning in redder states again or, over time, essentially sweep all of the Senate seats in blue and purple states.

Despite Republicans defending 22 of the 35 seats being contested this November, only a pair of those are in states where Democrats are currently very competitive: Maine, which consistently votes Democratic for president but also has the only Republican senator from a Kamala Harris-won state, Susan Collins; and North Carolina, which consistently votes Republican for president but often elects Democrats in other statewide races. Meanwhile, Democrats have to defend a couple of Trump-won states, namely an open seat in Michigan and the Georgia seat held by Sen. Jon Ossoff (D). We are upgrading Ossoff's race to Leans Democratic—more on that below—but these other three races remain Toss-ups. Holding Georgia along with all of their other seats and flipping Maine and North Carolina would get Democrats to 49 seats—still two short of the 51 they need for a majority. Democrats have attracted credible recruits in additional, Republican-held seats, most notably Alaska and Ohio, but they may just run into a red wall even if the political conditions are very favorable in November.

A New York Times/Siena University poll helps illustrate what we mean. That poll, released last week, showed Trump's approval rating at 40% approve and 56% disapprove among registered voters, with Democrats leading Republicans by 5 points on the House generic ballot. Both findings are roughly in line with current polling averages of Trump approval and the generic ballot; they're also in the ballpark of what we saw around this time eight years ago (the Democrats did have a more robust generic ballot polling lead, though).

Surveying the findings, the Times's chief political analyst, Nate Cohn, noted how Trump's gains in the 2024 election among younger and more diverse voters had evaporated. "Mr. Trump's approval rating by demographic group looks almost exactly as it did in Times/Siena polling in the run-up to his defeat in the 2020 presidential election. If anything, young and nonwhite voters are even likelier to disapprove of Mr. Trump than they were then, while he retains most of his support among older and white voters," he wrote.

It's that last observation that accentuates the challenge for Democrats in the Senate. Even with Trump in a weakened state, the floor of Republican strength with white voters in some of the states that feature on this year's Senate map—such as whiter-than-average Iowa and Ohio, for instance—may very well be strong enough to hold up even in a 2018-style environment. And in states that are more diverse—like Florida and Texas—Republicans can probably afford to lose their gains accrued over the course of Joe Biden's presidency and still come out ahead. Continue reading

2026 congressional midterm calendar: when each state is voting 
By Daniela Altimari of Roll Call

Primary season for Senate and House elections kicks off on March 3, with contests in Arkansas, North Carolina and Texas. It concludes, 196 days later, in Delaware.

In between, millions of dollars will be spent as candidates hustle for votes. Hanging in the balance is control of both the House and Senate, as well as governors' offices and other key state-level roles.

But first, there's some unfinished electoral business from 2025 to resolve: Texas, New Jersey and Georgia will hold special elections to fill House vacancies. The death of California Republican Doug LaMalfa will also result in a special election this year, but Gov. Gavin Newsom has yet to set a date.

As we look ahead to key primary contests of 2026, it's important to remember that most fields have not yet been set and there's time for more candidates to jump in. Also, several states require primary winners to secure a majority of the vote, so those contests may be decided by runoffs.

One of the most consequential and costly primaries will occur on March 3, when Texas Republicans select their Senate nominee. The battle pits longtime Sen. John Cornyn against two challengers, state Attorney General Ken Paxton and Rep. Wesley Hunt. Texas Democrats have their own competitive primary, featuring Rep. Jasmine Crockett and state Rep. James Talarico.

Texas is also home to dozens of contested House primaries under a new map state Republicans approved last year. Under state law, if no one crosses 50 percent of the primary vote, the top two finishers will compete in a May 26 runoff.

March will also see a big Democratic primary in Illinois, where Reps. Raja Krishnamoorthi and Robin Kelly and Lt. Gov. Juliana Stratton are vying to succeed retiring Sen. Richard J. Durbin. The state is hosting several competitive House primaries for open seats in the Chicago area too. 

May will bring another round of high-profile primaries. Ohio votes on May 5, when voters in the 9th District — redrawn further in Republicans' favor — will choose a Republican opponent for vulnerable Democratic Rep. Marcy Kaptur. 

Another battleground race will be set on May 12, when Nebraska voters pick their nominees for the 2nd District, where GOP incumbent Don Bacon is retiring. 

The six states voting on May 19 include Pennsylvania, home to a handful of battleground House primaries, and Kentucky, where Republicans have a hard-fought contest between Rep. Andy Barr, former state Attorney General Daniel Cameron and businessman Nate Morris for the seat of former Senate Majority Leader Mitch McConnell. Continue reading 

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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