04/24/2026
In her recent President’s Message, Dr. Akpamgbo provides an overview of the key legislative, funding, and vaccine policy issues affecting primary care access and physician sustainability across Oregon. Read her full message below👇
OAFP continues to closely monitor developments related to Medicaid quality improvement funding. While Oregon was able to stabilize 2025 funds, additional cuts are anticipated. In October, OAFP Executive Director Betsy Boyd-Flynn provided testimony for the Oregon Health Authority’s Metrics and Scoring Committee to outline the implications of losing Quality Incentive Pool (QIP) funds. Quality reporting represents a significant financial burden for clinics and is a major contributor to stress and burnout among primary care teams. Although clinics have invested substantial effort to demonstrate improvements in care, the return on that investment is diminishing. As performance metrics improve, many clinics are also reaching the practical limits of achieving statistically meaningful gains.
QIP funds have been critical in sustaining this work. OAFP urged legislators that if these funds are not restored — or are further reduced — quality measures should be narrowed to those most directly tied to improving access to care. New patient wait times to see a family physician in Portland have reached 45 days, and access consistently ranks as the top priority for patients in the health care system. To address this growing concern, Betsy encouraged the committee to refocus efforts on ensuring Oregon residents have access to coordinated, high-quality, team-based comprehensive primary care.
OAFP will continue to closely track these decisions and advocate for adequate funding that supports the health and well-being of Oregon’s most vulnerable communities, while protecting our primary care teams from burnout. The Oregon Health Policy Board recently voted to create a Primary Care Strategy Committee and OAFP is hopeful we will have a representative on the committee.
🩺Oregon Receives Major Rural Health Investment
There is also positive news to report. Rural health transformation plans are continuing to take shape through the Oregon Health Authority (OHA), and OAFP is working to position the Oregon Residency Collaborative Alliance for Family Medicine (ORCA-FM) to support key workforce components of these efforts. In December, the Centers for Medicare and Medicaid Services (CMS) announced that Oregon will receive $197.3 million to support rural health care communities. These funds are intended to strengthen the rural health workforce, modernize facilities, and support care models that bring services closer to patients’ homes.
While OAFP is grateful for this investment and looks forward to helping ensure the funds are used effectively, concerns about the state’s Medicaid budget remain. CMS rules limit the use of these funds, allowing no more than 15 percent to be allocated directly to provider payments — despite the financial strain many providers face from reduced Medicaid reimbursement. A recent Oregon Public Radio report noted that 14 of the state’s 37 rural hospitals lost money caring for patients in 2025.
“While this much-needed boost can’t make up for the substantial federal funding cuts we anticipate in the coming years, OHA is committed to using this opportunity to support as many promising and sustainable rural health solutions as possible,” said the OHA Health Policy & Analytics Director in a press release.
🩺OAFP Continues to Monitor Immigration Enforcement Issues
Recent immigration enforcement actions have sparked protests and concerns in our communities. Just a few days after an ICE agent fatally shot Renee Nicole Good in Minnesota, a Border Patrol agent shot and wounded two people in Portland. Following the Oregon shooting, Portland Mayor Keith Wilson demanded an investigation and called ICE to halt operations in the city.
There are many negative repercussions related to immigration enforcement, including members of our communities being too scared to access health care. The AAFP is clear in its support of basic human rights and affirms that standards of care should be upheld without compromising the rights of migrant, asylee, or refugee patients. The Academy also supports equal privacy protections for medical records, regardless of documentation status. In her column Dr. Eva Galvez, Chair of the OAFP Task Force on Health Impacts, discusses how immigration enforcement is affecting care in our communities and highlights a proposed bill that would prohibit immigration enforcement from accessing non-public areas of clinics and hospitals without a valid judicial warrant.
🩺Revised CDC Immunization Guidance Sparks Concern
In January 2026, the Centers for Disease Control (CDC) announced significant changes to its childhood immunization schedule, reducing the number of vaccines recommended for all children. Under the revised guidelines, the CDC limited its universally-recommended vaccines to measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B (Hib), pneumococcal disease, HPV, and varicella. The CDC now recommends vaccination against respiratory syncytial virus (RSV), hepatitis A, hepatitis B, dengue, meningococcal ACWY, and meningococcal B only for high-risk populations. The CDC also recommends that rotavirus, COVID-19, influenza, meningococcal disease, hepatitis A, and hepatitis B be considered for children through shared clinical decision-making.
OAFP is deeply concerned about the potential impact of these changes on the health of patients of all ages and we do not support the updated CDC schedules. These revisions rely on a comparative assessment of international immunization schedules and are not based on new evidence or research. This approach ignores critical differences in health care systems and disease burden and discounts the expertise of family physicians who are committed to protecting children from preventable disease and harm.
Instead, we encourage our members, their families, and their communities to follow immunization schedules grounded in the best available science. The AAFP’s recommended schedule can be found in the Immunizations and Vaccines section of its website and also on pages 22 and 23 of this magazine. Thank you to those members who have utilized AAFP’s Speak Out to voice concerns with your congressional members. Please continue to keep an eye out for more updates on vaccine policy changes and for opportunities to make your voice heard.
OAFP will continue advocating for policies rooted in evidence, focused on access to care, and supportive of family physicians, their teams, and the patients they serve.
