Advocacy & Public Policy

Kidney Health Advocacy

A Message From ASN President Prabir Roy-Chaudhury, MD, PhD, FASN

Dear Colleague:

Dear Colleague,

Thank you for being a member of the American Society of Nephrology (ASN).

This June, ASN continued to advance critical kidney health policy priorities that support people living with kidney diseases and their kidney care teams. I'd like to highlight several important ASN advocacy efforts and encourage your continued engagement in ASN's policy priorities as we move into the summer months.

1) Championing Kidney Research and Protecting the NIH Budget

ASN remains steadfast in its support for the National Institutes of Health (NIH), and in particular the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), amid proposed cuts and reorganization. Alongside partners in the kidney community and other research advocacy champions, ASN has urged Congress to ensure that the legally appropriated FY 2025 NIH funds are released, and to block the proposed deep cuts and restructuring in FY 2026. ASN has also called for Congress to provide $51.303 billion for NIH in FY26, including a proportional robust funding increase of no less than $207 million for NIDDK. As the appropriations process unfolds, ASN will continue to advocate for Congress to maintain its steadfast commitment to funding research and reject calls to shortchange the nation's scientific and medical research ecosystem.

In response to growing concerns about political interference in scientific research, over 300 NIH scientists have signed the Bethesda Declaration. Individuals who are interested in supporting this declaration may join the grassroots campaign organized by Stand Up for Science and sign a public letter of support.

2) Addressing the J-1 Visa Pause Impacting International Medical Graduates

In early June, the Department of State announced a temporary pause in processing J-1 visas for international medical graduates (IMGs). This development was especially alarming for nephrology, where nearly two thirds of incoming fellows are IMGs. ASN took swift action by launching a public petition to raise awareness of this issue and was one of the first organizations to send a letter to the Secretary of State Marco Rubio calling for the exemption of all J-1 IMG visa applicants from the pause, and to instead, expedite visa processing and related vetting for this critical group. Any potential disruption posed a direct threat to the thousands of incoming physicians scheduled to begin work at U.S. hospitals as residents and fellows in July.

Following ASN's advocacy efforts, the Department of State issued a diplomatic cable on June 18 that lifted the pause on new visa appointments, and prioritized J-1 physicians for visa interview scheduling. The cable instructed embassies to prioritize visa interviews for physicians applying for a J-1 visa for educational exchange and students looking to "study at a U.S. university where international students constitute 15 percent or less of the total student population".

3) Defending Against ACIP Reconstitution and Ensuring Vaccine Access

ASN joined the broader "House of Medicine" to express deep concern to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. over his decision to dismiss all 17 current Advisory Committee on Immunization Practices (ACIP) members within the Centers for Disease Control and Prevention (CDC) and to reconstitute the committee. ASN was the only organization from the kidney community to join this effort to emphasize how ACIP's independent, expert-led review is essential for maintaining public trust, vaccine coverage, and disease protection.

This was followed up by an open letter to the American public in which ASN reaffirmed its support for influenza, RSV, and COVID‑19 vaccination to reduce preventable illness, hospitalization, and death, while urging insurers and public health partners to guarantee access without cost-sharing.

4) Representing the Kidney Community at the American Medical Association (AMA)

ASN is advancing its advocacy priorities through its participation in the AMA and at AMA's Annual Meeting this month in Chicago. ASN highlighted the challenges facing nephrology to guarantee access to innovative and essential kidney care for pediatric and adult patients, as well as the need for common sense relief for physicians from undue prior authorizations, and provided important context about our system of kidney transplantation, concerning cuts to Medicare and Medicaid, attacks on science and vaccines, and burgeoning workforce challenges. A full summary of the meeting is available in the latest ASN Podcast episode.

ASN is part of the Transplant Caucus within AMA along with several other organizations including, the Renal Physicians Association (RPA) and the American Society of Transplant Surgeons (ASTS). More than one transplant-related issue was discussed within various AMA reference committees, and one came to a vote within the full House of Delegates. ASN was proud to collaborate with members of the Transplant Caucus to help shape a positive outcome for the proposed resolution, related to access to organ transplantation. By providing perspectives from the health professionals immersed in kidney and other organ transplantation on a day-to-day basis, ASN, ASTS, RPA, and other Transplant Caucus members ensured the final AMA policy aligned with expert opinion.

ASN is also a member of both the Office-Based Facility Association (OBFA) and the Dialysis Vascular Access Coalition (DVAC). ASN supported both groups' resolution related to decoupling disposable items over $500 from the physician fee schedule.

5) Shaping the Future of Kidney Care

ASN provided detailed feedback to a request for information from the Centers for Medicare & Medicaid Services (CMS) and the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC Health IT). ASN's response urges CMS and ASTP/ONC to prioritize digital health tools tailored for kidney patients, ensure open, standards-based data sharing, improve access to claims, clinical, and transplant data, and align regulations to reduce patient burden and support value-based kidney care.

ASN also submitted comments to Battelle's Partnership for Quality Measurement (PQM) as part of the Spring 2025 Measures Endorsement & Maintenance (E&M) cycle, which is the process by which quality measures are evaluated for endorsement and potential inclusion in Medicare's quality measurement programs. For this cycle, ASN submitted comments on measures related to the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey. ASN highlighted concerns about low survey response rates and limited patient engagement and emphasized the growing need for a home dialysis counterpart to the ICH-CAHPS survey.

Most importantly, your voice is vital to these efforts with ASN being the conduit through which your voice can be heard. I therefore encourage you to visit the ASN Legislative Action Center to learn more about how you can help advance kidney health policy priorities.

Thank you again for your continued partnership and advocacy on behalf of those living with kidney diseases.

Sincerely,

Prabir Roy-Chaudhury, MD, PhD, FASN
President

Advocating for Transformative Change

ASN—both individually and as a member of healthcare, medical, and scientific coalitions—routinely engages Congress and the Trump Administration, advocating for policies to create transformative changes in kidney health. ASN relies on its Health Care Justice Committee, Policy and Advocacy Committee, Quality Committee, and Transplant Policy Committee when formulating, prioritizing, and accomplishing annual policy priorities. A summary of ASN's most recent advocacy efforts follows—including for fiscal year (FY) 2026 kidney health research—in reverse chronological order.

Additional Advocacy Resources

April 2025: On April 16, a 64-page copy of the Department of Health and Human Services' Fiscal Year (FY) 2026
Discretionary Budget "Passback" was leaked. A "passback" is an annual document that the White House
Office of Management and Budget sends to agency heads outlining funding priorities for that
agency in the upcoming president's budget. ASN, in collaboration with the broader scientific and medical community, is actively monitoring the FY 2026 budget and appropriations process. An in-depth analysis of the "passback" can be viewed here.

February 2025: How Trump's Medical Research Cuts Would Hit Colleges and Hospitals in Every State (New York Times).

Council on Governmental Relations Facilities and Administrative Cost Reimbursement Advocacy Materials.

Association of American Medical Colleges Advocacy Resources on Facilities & Administrative (F&A) Costs:

• A fact sheet outlining key messages and a frequently asked questions overview.
• A comparison of foundations' support for F&A to government support.
• An infographic illustrating what types of expenses are and are not supported by F&A reimbursement.

January 2025: Research!America releases results of national survey showing Americans want President and Congress to assign higher priority to medical progress.