America’s health depends on doubling down on primary care | Viewpoint

It is 2026 and America is sick.

Chronic diseases now account for 90% of our $4.9 trillion in annual health care spending. Yet, the U.S. allocates less than 5% of total health expenditures to primary care, a figure that lags far behind other developed nations. This underinvestment has left us with a shrinking primary care workforce and millions of Americans without a usual source of care—a trend we cannot allow to continue.

President Trump was right to sound the alarm. His first term saw historic investments in primary care: updates to evaluation and management codes, telemedicine payment parity, navigating the COVID-19 pandemic through Operation Warp Speed, issuing over 1,000 new graduate medical education slots and the creation of new residency positions. These reforms helped family physicians weather turbulent times in health care and laid the groundwork for a healthier America.

But now is the time for President Trump and his administration to double down.

To truly make our country healthy, we must build on these gains and confront the chronic disease crisis head on. The path forward is clear: invest in primary care and ensure every American has a lifelong relationship with a primary care physician.

The President’s team at the Centers for Medicare and Medicaid Services and the Center for Medicare and Medicaid Innovation is pursuing smart reforms. For example, the recently implemented 2026 Medicare physician fee schedule made meaningful changes to better reflect the time physicians spend with patients. It streamlined documentation, and the G2211 code provides further relief by more accurately compensating family physicians for the complex, longitudinal care they provide. These changes are already making a difference.

Other countries, as noted by the Organization for Economic Co-operation and Development and the Commonwealth Fund, have proven that greater investment in primary care works. Their citizens live longer, healthier lives and better yet, they spend less doing it. The U.S. must do the same. A lack of investment in primary care is directly linked to declining health status, unsustainable health care costs and using resources on remedies and interventions rather than health and prevention.

But we must go further, and the country’s primary care physicians stand ready to chart a new course. Here’s how:

· Recruit and retain the next generation of family physicians. Waive interest on federal student loans for family physicians during their three years of residency training and for their first 10 years in practice.

· Expand access. To promote increased access to care for all Americans, the President should work to further promote direct primary care (DPC) as a comprehensive primary care model by allowing Medicaid beneficiaries to contract with DPC practices. The President should also take steps to protect independent practices and clinical autonomy and preserve patient choice.

· Invest in community health centers. Double the annual investment in community health centers to bring primary and dental care to underserved communities.

· Remove barriers to care. Eliminate cost-sharing for visits to primary care physicians for individuals and families with employer-sponsored insurance.

· Promote rural service. Offer an annual $50,000 tax credit to each primary care physician practicing in a rural community.

· Protect maternity care. Extend Federal Tort Claims Act liability protections to family physicians and obstetricians providing obstetrical care in rural communities.

· Support innovation. Build on advancements of mRNA breakthroughs during Operation Warp Speed to develop life-saving therapeutics beyond vaccines.

These steps will not only strengthen the primary care workforce but also ensure every American has access to high-quality, preventive care. The stakes could not be higher. We face a chronic disease pandemic, worsening mortality rates, rising health care costs and access gaps. Without decisive action, these challenges will haunt our health care system for generations.

Policymakers must recognize that historic underinvestment in primary care is at the root of our problems. Let’s build on what works, redesign what doesn’t and make a healthier America a reality that all patients can live in.

Shawn Martin is the EVP and CEO of the American Academy of Family Physicians.