Advocacy

On July 3, 2025, the House of Representatives passed H.R. 1 One Big Beautiful Bill (OBBB) along mostly party lines following the Senate’s amendments earlier this week. President Donald Trump signed the bill into law on July 4, 2025. Over the next decade, the bill will extend $2.9 trillion for tax breaks for the wealthy at the expense and detriment of children, families, and hard-working Americans. Billions of dollars will be funneled toward federal agencies for detaining immigrants, constructing walls along the southern border, and military weapons manufacturing. 

Rather than reducing barriers in accessing healthcare and ensuring food security for Americans, this bill will require Medicaid patients to pay up to $35 copays for medical services and institute additional work requirements to qualify for Supplemental Nutrition Assistance Program (SNAP) benefits while simultaneously cutting funding for the SNAP by over $300 billion over the next decade. Rural communities and communities of color will be deeply affected by these cuts, severely limiting access to affordable care.

How will some of these changes affect you as medical students and physicians?

National APAMSA strongly condemns the signing of this cruel bill that primarily benefits the wealthy while leaving millions of Americans without healthcare or food on the table. As expressed in our previous Joint Statement with SNMA, LMSA, AMSA, SOMA, and MSDCI, we are deeply disappointed by these decisions that will harm patients and exacerbate the physician shortage. OBBB will have lasting repercussions on American health and well-being, further deepening inequities in healthcare and socioeconomic success. These provisions represent a stark disconnect between national leaders and public interests despite polls that indicate almost two-third of Americans view this bill unfavorably. We urge policymakers to rectify and reverse these changes and work with constituents to produce new legislation that will strengthen our nation and alleviate health disparities.

Take action:

1. Register to Vote: Exercise your privilege to vote and shape the future by electing officials that reflect your priorities. 
   1. The Medicaid cuts are not projected to be enacted until after the 2026 Midterms, which makes 2026 a crucial moment for voters to show their elected officials that voting against their constituents’ best interest will have consequences.
2. Become civic engagement advocates through Vot-ER’s Healthy Democracy Campaign
3. Please contact your members of Congress to express your opposition towards these policies. You can use 5 Calls to quickly locate your representatives’ numbers and be prepared with prompts that can help you discuss this particular bill and other issues at ease. 

The first day of June marks a month-long celebration of the LGBTQIA+ community. Honoring the progress and the vibrance of this community has been especially important with escalating attacks on the LGBTQIA+ community’s rights. 

On June 18, 2025, the Trump Administration announced the termination of the 988 national suicide prevention hotline’s support for LGBTQIA+ callers beginning July 17, 2025. Through providers like the Trevor Project, the 988 Lifeline has served almost 1.3 million youth since the launch of the program in September 2022. Soon, calls/texts will be routed to general crisis centers without LGBTQIA+ specialization. The shutdown of this hotline will have an enormous impact, considering that 1.8 million LGBTQIA+ young people consider suicide every year and are four times more likely to commit suicide than their peers. 

On the same day, transgender rights were also seriously curtailed by the new Supreme Court ruling United States v. Skrmetti, in which they upheld Tennessee’s ban on gender affirming care for transgender youth. This decision has wide-ranging implications: it maintains similar bans on gender affirming care across 25 states, which range from prohibiting providers from administering hormones or puberty blockers to prohibiting gender-affirming care surgeries. Although some states have enacted policies to shield patients receiving and/or providers practicing gender affirming care from civil or criminal charges, over 100,000 transgender youth living outside these areas will still face significant barriers to care. 

National APAMSA condemns these egregious and cruel decisions against the LGBTQIA+ community, who are already a vulnerable and marginalized population. As we approach the end of this month of celebration, this community faces even greater challenges that infringe on the right to exist and to thrive as their authentic self. Guided by our policy compendium, we stand firm in the belief that all patients, including but not limited to those based on their age, color, sex, gender, and sexual orientation, deserve equitable, evidence-based care. We call on medical professionals and trainees to continue advocating for sexual and gender minorities, and implore local, state, and federal leaders to promote health equity and fight inequities affecting the LGBTQIA+ community. 

Please contact your members of Congress to express your opposition against these efforts that degrade and inflict pain on LGBTQIA+ youth. You can use 5 Calls to quickly locate your representatives’ numbers and be prepared with prompts that can help you discuss this particular bill and other issues at ease. 

Sign the petition to voice your concern about the end of the LGBTQ Youth 988 Hotline: https://actionnetwork.org/petitions/protect-988-suicide-and-crisis-lifeline-for-lgbtq-youth/ 

LGBTQIA+ Care Is Under Attack.

Patients and professionals are at risk. These are recent federal actions as of June 27, 2025:

• Bans on gender-affirming care sweeping across our nation 
• Terminating crisis lifelines for LGBTQIA+ youth
• Pressuring providers into silence

Criminalizing Providers: H.R. 3492

Congress is advancing H.R. 3492, which would:

• Make it a federal crime to provide gender-affirming care to minors
• Penalize clinicians with up to 10 years in prison

This is not about safety. It’s about eroding medical autonomy and the duty of healthcare providers!

Take action now: action.aclu.org/send-message/protect-trans-care-now

The “Chilling Effect” Is Already Here

The phenomenon describes providers and institutions withdrawing from offering LGBTQIA+ care out of fear of legal, professional, or political consequences. 

Across the U.S., providers are:

• Asking to be removed from LGBTQIA+ directories
• Canceling trainings and support programs
• Backing away from DEI partnerships

Protect Your Patients and Yourself

Even in restrictive states, we urge providers to use your voice and position to support LGBTQIA+ patients further by:

• Documenting decisions clearly and legally
• Using encrypted, secure communication tools
• Sharing vetted provider referral lists confidentially
• Consulting with organizations like GLMA, ACLU, or Lambda Legal if in doubt

Ask your employers for clear legal guidance and know your rights.

Students: Don’t Be Discouraged

We are the next generation of providers.

• Keep learning about gender-affirming care best practices
• Seek out affirming preceptors or telehealth shadowing
• Use platforms and private peer networks to build experience
• Document and report any discriminatory practices during your training. You are protected.

How to Push Back as Providers (Legally + Ethically)

• Advocate for inclusive care policies and language
• Push for policy reviews on gender and identity
• Join or form affirming clinician coalitions locally and nationally
• Know how to refer patients to care in other states or via Telehealth

What Can You Still Do as Healthcare Professionals

Clinical Practice

• Affirm: Use patients’ names/pronouns. Document care transparently.
• Refer Safely: Maintain a trusted network of LGBTQIA+ providers (start with OutCare).
• Provide Access: Offer virtual mental health services where care is restricted.
• Trauma-Informed Approach: Acknowledge lived experiences. Normalize emotional responses to discrimination.

Education & Advocacy

• Train colleagues in LGBTQIA+ cultural competency (OutCare, GLMA offer free modules)
• Advocate within your institution for inclusive policies, even when statewide law is regressive
• Build cross-discipline alliances: social workers, nurses, legal counsel, DEI officers

Resources for LGBTQIA+ Youth & Their Support Circles

If you are LGBTQIA+ youth, parents, teachers, and/or allies, we stand with you.

Crisis Support & Hotlines

• The Trevor Project — 24/7 Crisis Support independent of 988.
  1-866-488-7386 | Text “START” to 678678
  thetrevorproject.org/get-help
• Trans Lifeline — Peer-run and confidential.
  1-877-565-8860
  translifeline.org
• LGBT National Help Center — Youth and senior talk lines.
  1-800-246-7743
  lgbthotline.org
• Love is Respect — National teen dating violence support including LGBTQIA+ relationships.

1-866-331-9474 | Text “LOVEIS” to 22522

loveisrespect.org

Support & Education for Families

• PFLAG Chapters
  pflag.org
• Q Chat Space – Peer-moderated online groups for LGBTQIA+ teen
  qchatspace.org

References

“We’re Not Going Anywhere: LGBTQ+ Health Equity Must Not Be Abandoned”

OutCare Health (2025). https://www.queerty.com/were-not-going-anywhere-lgbtq-health-equity-must-not-be-abandoned-20250605

“Trump Administration Orders Termination of National LGBTQ+ Youth Suicide Lifeline Effective July 17th”

The Trevor Project – 988 Shutdown Report. Published: June 18, 2025.

https://www.thetrevorproject.org/blog/trump-administration-orders-termination-of-national-lgbtq-youth-suicide-lifeline-effective-july-17th/

“Protect Trans Care Now: Tell Congress to Oppose the Criminalization of Gender-Affirming Care”

ACLU Action Page – H.R. 3492

https://action.aclu.org/send-message/protect-trans-care-now

“UC Berkeley experts react to U.S. Supreme Court ruling on medical care for trans minors”

UC Berkeley News. Published: June 18, 2025.

https://news.berkeley.edu/2025/06/18/uc-berkeley-experts-react-to-u-s-supreme-court-ruling-on-medical-care-for-trans-minors/

Fenway Health – The Fenway Institute

https://fenwayhealth.org/about/commitment-to-lgbts/

GLMA On-Demand CE/CME Access

https://www.glma.org/on-demand_ce_cme.php

Campaign for Southern Equality

https://southernequality.org/emergency-help/

Lambda Legal — State Specific Policies

https://lambdalegal.org/search/?keyword=webinar+&issue-area%5B%5D=21724&start-date=&end-date=&sort=desc

On Saturday, June 14, 2025, Arthur Folasa Ah Loo, 39, was fatally shot in Salt Lake City, Utah. He was an innocent bystander participating in the “No Kings” protest—a nationwide day of defiance denouncing President Donald Trump’s authoritarian actions such as threatening freedom of the press and speech in universities to authorizing mass deportations without due process. Ah Loo was caught in the line of fire by a stray bullet when unsanctioned armed peacekeepers shot a nearby man who pulled out an AR-15 rifle during the protest. Ah Loo was taken to the hospital, where he eventually died. 

Ah Loo devoted his life to serving his family and the Utah Pacific Islander community. As a former Project Runway contestant and self-taught fashion designer from Samoa, he relentlessly advocated for Pacific Islander artists. His own designs challenged fashion norms by merging elements of modern design with traditional Pacific Islander attire, showcasing his heritage on a global stage. In his free time, Ah Loo voluntarily tailored and created clothing for people in need, often refusing payment for his work. 

We, at National APAMSA, are deeply saddened by the loss of Ah Loo and his powerful voice for representation and diversity in the fashion industry and Pacific Islander community. His loss is deeply felt not only by the Samoan and wider Pasifika communities, but also by anyone who believes in the power of creativity to inspire change. To Ah Loo’s family, his wife Laura and their two young children, and the community who are mourning him, we send our deepest condolences.

APAMSA reaffirms its stance denouncing gun violence as expressed in our policy compendium. The death of Ah Loo was senseless and avoidable, reflecting the devastating consequences of unchecked violence, open-carry policies, and failure to ensure protest safety. The presence of untrained, armed peacekeepers acting outside of official oversight directly contributed to this tragedy. This instance also raises questions about who has power, who is protected, and who is left vulnerable—even when their intentions are peaceful. We urge lawmakers, protest organizers, and community leaders to prioritize public safety. No one should have to fear for their life while standing for what they believe in. 

If you would like to support his family, please consider donating to the GoFundMe in honor of Arthur Folasa Ah Loo.

Following the Trump Administration’s plan to push for mass deportations, Immigration and Customs Enforcement (ICE) agents raided multiple communities in the Los Angeles area on Friday June 6, 2025, detaining over 100 people. This action mirrors similar immigration arrests in cities across the nation such as San Diego and Chicago. Federal agents, often equipped with military gear and traveling in armored vehicles, have increasingly targeted workplaces and courtrooms to increase arrests and deportations of undocumented immigrants in the United States. This surge in activity comes amid ongoing concerns about unsanitary conditions, inadequate health and medical treatment, and other rights violations at detention facilities. Since January 2025, further policy changes have eliminated protections for locations such as schools, hospitals, and places of worship from ICE activities. This has instilled fear in undocumented individuals, making them hesitant to access essential health services due to the risk of arrest and detention.

At National APAMSA, we are dismayed by these immigration sweeps, which directly threaten the health and safety of immigrants, a concern explicitly expressed in our policy compendium. These raids prioritize quotas set by the Trump Administration rather than ensure public safety, leading to overcrowding and an increased number of deaths in ICE facilities. A 2024 report by the American Immigration Council found no correlation between ICE operations and lower rates of violent crime despite the Trump Administration’s repeated claims that many immigrants are “committing vile and heinous acts against innocent Americans.” We have seen the rights of immigrants being violated, despite decades of legal precedent of equal protections afforded by the Constitution for all persons in the United States. Please help us stand up for the rights of immigrants and inform others about their fundamental protections 

Call to Action

• Speak with your Congressional representatives about your concern for the violation of immigrant rights. To find your Representative and Senators, please use the following website: https://www.congress.gov/contact-us 
• Inform all community members of their rights and about available resources. Please see below for a list of resources.

Resources: 

ACLU – Know Your Rights

Immigrant Defense Project – Know Your Rights infographics and fact sheets (also available in multiple languages) 

Stop AAPI Hate – Community Resources

Immigrant Legal Resource Center – Red Cards to place in cars and at home

Email Script to Congress

Subject: Urgent: Oppose ICE Raids and Military Violence Against Protesters

Dear [Representative/Senator Last Name],

My name is [Your Name], and I am a constituent living in [Your ZIP Code]. I am writing with deep concern about the Trump administration’s cruel and inhumane immigration enforcement and violent suppression of peaceful protests.

I urge you to take a firm stand against ICE raids in Los Angeles and throughout the U.S. These raids do not just target undocumented immigrants — they also intimidate and harm documented immigrants. Families are being separated, children traumatized, and entire communities pushed into fear and silence.

Undocumented immigrants are the backbone of our country. They do the labor that many Americans are unwilling to do, often under brutal and hazardous conditions. From working in fields under extreme heat and air pollution, to dangerous construction sites and underregulated factories, these workers sustain critical industries — with little or no workplace protection.

Despite these conditions, undocumented immigrants pay over $37.3 billion in state and local taxes every year, including $8.5 billion in California alone. They are our neighbors, colleagues, and essential contributors to our country.

And yet, the Trump administration responded with cruelty — targeting not just those undocumented, but also documented immigrants with new restrictions, denials, and deportations.

To make matters worse, this administration has used the National Guard and military force against peaceful protesters, weaponizing power against people who are simply exercising their First Amendment rights. Peaceful dissent is a hallmark of American democracy — not a threat to be met with tear gas and rubber bullets.

I urge you to:

• Publicly condemn ICE raids and the targeting of immigrant families.
• Oppose any militarization of protest response.
• Support legislation that protects immigrant communities and ensures humane treatment.
• Defend our right to protest without fear of violence or retaliation.

Please act now to protect our communities and uphold justice.

Sincerely,

[Your Name]

Call Script: 

Hi, my name is [Your Name], and I’m a constituent calling from [Your City, ZIP Code].

I’m calling to express my deep concern about the Trump administration’s cruel and aggressive immigration enforcement and the violent use of military force against peaceful protesters.

I urge [Representative/Senator’s Last Name] to:

• Publicly condemn ICE raids, especially those happening in Los Angeles and across the country. These raids tear families apart and push entire communities into fear — including many documented immigrants.
  
• Oppose the militarization of protest responses. Peaceful protest is a constitutional right — not something to be met with tear gas or rubber bullets.
  
• Support legislation that protects immigrant communities and ensures they are treated with dignity and humanity.

Undocumented immigrants are the backbone of essential industries in our country. They work in harsh and dangerous conditions that many others won’t — often without protections — yet still contribute over $37 billion in state and local taxes.

We need leaders who will protect communities, not terrorize them. Please tell [Representative/Senator’s Last Name] to stand up for human rights and democracy.

Thank you.

On May 22, 2025, the House of Representatives passed H.R. 1 One Big Beautiful Bill Act, which contained disconcerting provisions aimed at cutting Medicaid funding by almost $700 billion over the next decade. Medicaid has been a central fixture for 83 million Americans, providing essential healthcare and long-term care for children, seniors, people with disabilities, and low-income adults. The Affordable Care Act’s Medicaid expansion to adults who earn up to 138% of the federal poverty level ($21,597 for a single adult) has insured millions of Americans with health coverage. These potential changes will deprive over 10 million Americans from healthcare coverage through Medicaid and disproportionately affect communities of color.

Medicaid has been linked to increased access in rural and disadvantaged areas and improved health outcomes like decreasing all-cause mortality by almost 2% and lowering maternal mortality. In a recent report authored by the Asian & Pacific Islander American Health Forum, the National Association for the Advancement of Colored People, the Leadership Conference on Civil and Human Rights and other national health organizations, Medicaid is the primary source of healthcare for almost 30% of people of color. 

Medicaid has consistently enjoyed broad bipartisan support. A recent poll demonstrates that most Americans—Democrats, Republicans, and independents alike—favor maintaining and increasing spending on Medicaid access. Forty states across the political spectrum have opted into Medicaid expansion, recognizing the program’s role in improving health outcomes, supporting rural hospitals, and reducing uncompensated care. Despite the overwhelming evidence that Medicaid is extremely popular across the political spectrum and saves lives, House Republicans have moved to sacrifice public health in favor of funding tax cuts that primarily benefit the wealthy. The harmful provisions in H.R. 1 stand in contrast to the values shared by voters of all political backgrounds who believe Americans should not be denied care due to their income.

The bill will attempt to cut costs by

1. Reducing the incentives and federal subsidies given to states for expanding Medicaid, specifically punishing any state that provides any health benefits or assistance to undocumented immigrants with lower expansion matches,
2. Establish cost-sharing and copays of $35 for services provided to anyone above the federal poverty level ($15,650 for a single adult),
3. Instituting stringent work requirements and eligibility verifications that burdens Medicaid recipients and state governments with more paperwork,
4. Prohibiting Medicaid payment to nonprofits and providers that focus on reproductive health, family planning, and abortion services like Planned Parenthood,
5. Removing gender affirming care as an Essential Health Benefit under the Affordable Care Act and prohibiting coverage for any Medicaid/CHIP recipient,
6. Suspending rules that streamline application and enrollment into Medicaid and for patients who qualify for the Medicare Savings Program (covers Medicare premiums and cost-sharing for low-income Medicare beneficiaries).

We strongly condemn any legislation aimed at limiting equitable access to Medicaid or attacking access to abortion services and gender affirming care. Among the many destructive changes also embedded in H.R. 1, the elimination of federal student loans and loan forgiveness programs will severely limit access for students from all backgrounds to pursue careers in medicine. This bill proposes a lifetime cap of $150,000 for federal graduate student borrowing, specifically for those enrolled in professional programs. This will potentially force students to rely on private loans with less favorable terms and fewer protections, undoubtedly compounding the physician shortages in the very communities that rely on us. 

At the heart of these proposed cuts lies an uncomfortable truth – healthcare is not a human right if equal access is not afforded to everyone regardless of socioeconomic class and immigration status. These actions go against the principles set by other nations, the World Health Organization, and the EU among others, highlighting the precarious path that the U.S. government is currently steering the country down. If passed in the Senate as is, the “One Big Beautiful Bill” will greatly harm patients across the United States and hamper the ability for physicians and other healthcare providers to serve their communities. 

Call to Action:

To Senators – We call on all senators to reject this bill to protect the American public’s interest and maintain our great nation’s founding principles of “Life, Liberty and the pursuit of happiness” 

To Medical Students – we urge all medical students to contact their Senators in Congress and demand a No vote on the “One Big Beautiful Bill.”

Signed,

Asian Pacific American Medical Student Association (APAMSA)

Student National Medical Association (SNMA)

Latino Medical Student Association (LMSA)

American Medical Student Association (AMSA)

Student Osteopathic Medical Association (SOMA) 

Medical Students with Disabilities and Chronic Illness (MSDCI)

Additional Resources:

Contact your Congressional Representatives: https://www.congress.gov/contact-us 

More information about federal student loans changes: Official Statement and infographic

Call or email your Representative today with a call script from our partner organization, Vot-ER: https://go.vot-er.org/0mAQQu

On April 28, 2025, Congress released a draft proposal to overhaul the federal student loan system, aiming to add limits to federal student loans, eliminate Grad PLUS loans, and drastically scale back current repayment plans and loan forgiveness options. For 75% of medical students who take out federal loans to pay for medical school, these new proposed rules will stifle the training of future physicians in a nation already facing a physician shortage among a growing and aging population. Congress is also discussing changes to reduce Pell Grants, which help fund undergraduate education for low-income students, including pre-medical students. 

APAMSA’s membership is made up of over 4,500 medical and pre-medical students from across the country, and our national organization opposes these alarming changes that will irrevocably damage medical education financing for tens of thousands of medical students and for the many other health profession students.

We urge students to spend 5 minutes of their time to reach out to their Congressional representative to demand the protection of federal student loans. Please send this to your fellow classmates – more people contacting means higher importance to our representatives.

To find your Representative and Senators, please use the following website: https://www.congress.gov/contact-us 

We have provided scripts that you can use in an email or in a short phone call to deliver your concerns about the proposed changes. Please feel free to adjust these scripts as you wish to better express your concerns. If you have voted for the Congressional representative or senator before, please mention that as a part of your statement. 

Version 1: 

Hi, my name is [NAME] and I’m a constituent from [CITY, ZIP].

Thank you so much for your continued support of our medical students and the future patients they’ll serve, especially in rural and underserved communities. I’m reaching out today not just as a student, but as someone who grew up in [brief personal background] and who relies on the Grad PLUS program to afford medical school. If this option were taken away, students like me would be forced to reconsider whether they can even afford to complete their training—despite our deep commitment to serving communities in need. I remain concerned about proposals to eliminate Grad PLUS or impose borrowing caps below the true cost of medical education. These changes would severely limit access for students from all backgrounds and risk worsening the physician shortage in the very communities that rely on us. I respectfully urge you to continue advocating for policies that protect access to medical education and ensure that future physicians can continue serving the communities that need us most. Thank you again for your leadership and for considering the impact this would have on students like me.

Version 2: 

Hi, my name is [NAME] and I’m a constituent from [CITY, ZIP].

I’m calling to urge [REP/SEN NAME] to protect funding for the federal student loan program and oppose the elimination of Grad PLUS loans and other loan repayment options. As a [medical student/pre-medical student] at [your school], access to federal student loans are crucial to the training of America’s future physicians. In order to provide the best care to our patients across the nation, we must be supported in our education.

Thank you for your time and consideration.

IF LEAVING VOICEMAIL: Please leave your full street address to ensure your call is tallied.