FFFM | A Seat at the Table: Affordability Working Group on Healthcare

In this episode of Fighting for Family Medicine, AAFP Vice President of Government Relations David Tully recaps the Academy's October advocacy efforts before talking with Maryland family physician Amar Duggirala, MD, about his experience representing family medicine at a congressional roundtable focused on health care affordability.

Tully begins with updates from across the AAFP's advocacy work, including the installation of Kisha Davis, MD, MPH, FAAFP, as AAFP president and her participation in a federal discussion on preventing congenital syphilis. He also highlights AAFP advocacy supporting reliable telecommunications and telehealth access in rural communities, protecting the patient-physician relationship as artificial intelligence becomes more common in health care, and improving insurance coverage, affordability and continuity of care. The episode also covers AAFP opposition to proposed H-1B-related fees and restrictions that could create additional barriers for physicians, trainees and other health care professionals entering the U.S. workforce.

The conversation then turns to rising health care costs and what those pressures look like inside a family medicine practice. Duggirala describes seeing patients face higher premiums, growing out-of-pocket costs and reduced benefits while struggling to afford medications, specialty care, testing, and even routine primary care visits. He explains why the presence of a practicing physician at the congressional roundtable mattered and how family physicians can help policymakers understand the real-world consequences of decisions that may appear effective on paper.

Duggirala also shares what he believes is missing from the national affordability conversation. His priorities include substantially increasing investment in primary care, reducing administrative burdens such as prior authorization and strengthening Medicare and Medicaid funding. He argues that greater access to high-quality primary care can prevent more expensive downstream care while improving outcomes for patients with chronic conditions.

The episode closes with a call for more family physicians to become involved in advocacy. Duggirala describes advocacy as an extension of caring for patients and encourages physicians to connect with their state chapters, participate in the AAFP Advocacy Ambassador Program and attend the Family Medicine Advocacy Summit to bring firsthand experiences from their communities directly to policymakers.

Episode hosts

David Tully - Vice President of Government Relations and member of the AAFP advocacy team

Amar Duggirala, MD - Family physician from Maryland and AAFP physician advocate

Resources / Links

• AAFP Member Advocacy

• AAFP Advocacy Ambassador Program

• Speak Out tool

• Share Your Story tool

• AAFP Response to Senator Wyden RFI on Health Care Coverage Reform – September 30, 2026

• AAFP Response to CMS RFI on MES IT Standards Program - September 23, 2026

• Joint AAFP-CAFM Response to FCC on Telehealth in Rural America - September 30. 2026

• AAFP Response to CMS RFI on MES IT Standards Program - September 23, 2026

• Joint Letter to DHS on Fee for Certain H-1B Petitions NPRM - September 23, 2026

Chapters

00:00 October advocacy roundup

01:01 New AAFP leadership and congenital syphilis advocacy

02:37 Rural connectivity, telehealth and AI policy

04:02 Improving health care coverage and affordability

04:51 H-1B physician workforce advocacy

06:03 Bringing the family physician voice to Congress

08:02 How rising health care costs affect patients

09:41 Why lawmakers need to hear from family physicians

12:24 What's missing from the health care affordability debate

16:37 How family physicians can get involved in advocacy