When policy uncertainty becomes a clinical burden

A call to action for the connected healthcare ecosystem

The ongoing federal government shutdown is another reminder of something most clinicians already know: what happens in Washington has an impact in your exam room. Policy uncertainty doesn’t just make for messy headlines — it becomes a clinical burden. Right now, millions of Americans and the practices that care for them are waiting to see whether Congress will extend the tax credits that made Affordable Care Act (ACA) Marketplace plans more affordable.

Those enhanced premium tax credits, introduced in 2021, expanded eligibility and increased subsidies so more families could keep their coverage. They’re set to expire at the end of 2025. Whether lawmakers renew or retire these tax credits will not only shape who stays insured, but also whether independent practices can keep their doors open and their communities healthy.

The cost of inaction shows up in the exam room

If these credits expire, the Urban Institute projects that 4.8 million people could lose insurance coverage next year — a 21 percent increase in the uninsured rate.

Ambulatory practices already run on thin margins. A sudden spike in uninsured visits could mean higher levels of unpaid bills and more patients skipping critical care they can’t afford. According to the Robert Wood Johnson Foundation, providers could face more than $32 billion in lost revenue and an additional $7.7 billion spike in uncompensated care in 2026 if these credits lapse and people lose coverage. For clinicians, that’s not a policy debate — it’s a question of whether patients will still show up for care when they need it, and whether practices can sustain the infrastructure required to serve them.

Short-term fixes keep the system stuck

Every time Congress passes a temporary extension — for premium subsidies, telehealth flexibility, or Hospital at Home programs — uncertainty ripples through the entire healthcare ecosystem. Practices delay investment decisions. Patients wait to schedule services. Innovation slows. The cycle of uncertainty keeps everyone reactive instead of building long-term progress.

As an industry, we need a comprehensive approach to healthcare reimbursement and coverage stability, not another series of short-term fixes. Policymakers should look beyond the next continuing resolution toward reforms that align incentives, modernize payment structures, and ensure consistent access to virtual and in-person care.

For clinicians, that’s not a policy debate — it’s a question of whether patients will still show up for care when they need it, and whether practices can sustain the infrastructure required to serve them.

Healthcare IT companies have a stake in stability

At athenahealth, we see firsthand how policy volatility affects both patients and providers. When reimbursement is uncertain, it disrupts the very progress that makes care more connected, efficient, and sustainable. The digital tools that help practices coordinate care, streamline administrative work, and enable high-value clinical actions depend on stable policy environments to deliver their full potential.

That’s why our advocacy extends beyond digital infrastructure. Earlier this year, we worked alongside our partners in Washington to help secure a long-overdue win for independent physicians: for the first time in five years, Medicare reimbursement rates are set to increase instead of decrease in 2026. It’s proof that consistent, coordinated advocacy can make a tangible difference — not just for policy, but for the practices and patients those policies serve.

This is a moment for technology companies to lean into advocacy and partnership — helping practices navigate change, quantify efficiency gains, and demonstrate the measurable value of digital continuity. Policymakers need clear evidence of how health IT accelerates coordinated care, reduces waste, and supports high-quality, lower-cost outcomes — and the ambulatory community is uniquely positioned to provide it.

That’s why we continue to actively engage policymakers — including at the White House over the summer — to highlight how connected technology improves outcomes and helps keep costs in check by reducing duplication, closing care gaps, and creating a more complete, data-driven picture of each patient’s health.

Predictability should be the norm, not the exception

No single piece of legislation will fix the coverage gap, and no single sector can fix it alone. But we all share responsibility for building a healthcare system that patients and clinicians can count on. Extending the enhanced premium tax credits is an immediate step toward that goal. The larger task is creating a stable, technology-enabled foundation for care that outlasts election cycles.

Because in the end, coverage decisions made in Washington determine what happens in exam rooms across the country — and whether the trusted relationship between a patient and their doctor can endure.