I am excited to join the JELF Advocacy Scholars Program this year. Current policy shifts have reinforced my belief that our responsibility to the care of children necessarily extends beyond the hospital walls. As faculty at the nation’s oldest public hospital, clinical practice has long informed my interest in advocacy work, and physician engagement now feels increasingly urgent.
Recent health policy changes will directly affect our patients’ access to care. The expiration of enhanced Affordable Care Act premium subsidies has raised affordability concerns, with recent CMS data indicating that Marketplace plan selections for 2026 are down by approximately 1.2 million enrollees compared to the same period last year. Importantly, these figures reflect plan selections rather than paid enrollment, and the full effects of subsidy reductions may not yet be apparent. Implementation of the Budget Reconciliation Act (H.R.1), including provisions affecting Medicaid eligibility and more frequent coverage redeterminations, may similarly contribute to coverage loss through procedural disenrollment and administrative barriers. Given the high proportion of pediatric patients covered by Medicaid, policies affecting eligibility and renewal processes will likely have amplified effects in pediatric subspecialty care. I am examining financial toxicity among pediatric solid organ transplant recipients and their families; I expect the evolving access barriers may further compound these pressures over time.
As medical information becomes increasingly fragmented and at times unreliable, clear communication by pediatrician advocates is essential to ensuring that patients and families receive accurate and consistent medical recommendations. This past month, the American Academy of Pediatrics published its independent 2026 immunization schedule, which has been endorsed by several leading medical and health care organizations. The schedule continues to recommend vaccines protecting against 18 diseases and maintains longstanding evidence-based immunization guidance, providing continuity amid recent changes to federal recommendations.
I look forward to joining colleagues in Washington, DC, at both ASPN Hill Day in March and the AAP Legislative Conference in April to engage in discussions directly affecting our patients and the care we provide. Last fall, I participated in our community’s virtual Hill Day, meeting with representatives in the Mid-Atlantic states to discuss priorities including NIH funding, vaccine policy, and modernization of the transplant organ allocation system. Those conversations further strengthened my commitment to advocating on behalf of our patients. It has been a privilege to join the JELF community and to work alongside thoughtful and dedicated colleagues whose passionate commitment to advocacy is truly inspiring.
Author: Marissa Lipton
Posted: March 2, 2026