Electronic Spring 2026 | Issue 66
Members from Area 4 Gather for 25th Annual Legislative Institute
By: Joshua Nathan, MD
Psychiatrists and policy experts from across the Midwest convened on February 7, 2026, for the 25th APA Area 4 Legislative Institute. The event, held virtually this year to expand its reach, focused on the evolving landscape of mental health policy, the integration of artificial intelligence in clinical practice, and the critical need for physician representation in government.
The morning session, organized for the first time by Dr. Joshua Nathan after several years of being organized by Dr. Shastri Swaminathan, served as a precursor to the Area 4 Winter Meeting. The program featured federal updates, state-specific advocacy reports, and keynote addresses from two physician-legislators.
Dana Doran, a federal lobbyist for the APA, provided a briefing on the legislative climate in Washington D.C. While highlighting the successful passage of a federal health program funding bill, Dana warned of "political gridlock" regarding drug pricing and ACA subsidies. A significant portion of the federal update focused on veteran care. The APA expressed formal opposition to a proposed Veterans Affairs (VA) requirement for written consent for psychiatric medications, characterized by advocates as an "unnecessary barrier" that could further stigmatize mental health care. On a positive note, Dana pointed to increased federal funding for maternal mortality research and the integration of primary and behavioral health care.
Amanda Blecha presented an overview of key legislative issues facing state associations, focusing on telehealth coverage, collaborative care models, and opposition to psychologist prescribing legislation. While 15 states have enacted laws requiring insurers and Medicaid to reimburse for collaborative care codes, there are ongoing efforts to expand reimbursement in additional states. Amanda also discussed the APA's position against psilocybin legalization before FDA approval and shared resources available to support state advocacy efforts, including CALF grants and AMA scope of practice partnership funding. The meeting covered several key topics, including the number of psychology prescribers in the country, which Amanda confirmed as 220. Attendees were reminded of the potential for APA leadership to testify in state legislative hearings via Zoom, with Amanda offering support for such efforts.
The Institute heard from Dr. Jeffery Bennet, the Area 4 representative to the APA PAC. Dr. Bennett and Area 4 leadership urged members to increase their participation in and donations to the APA PAC, noting that consistent advocacy is the only way to ensure medical expertise continues to shape public policy.
Delegates from across Area 4 reported on their various legislative battles and success. Illinois highlighted HB 1085, the landmark bill aimed at advancing mental health parity and establishing reimbursement floors for providers. Minnesota and North Dakota focused on protecting healthcare access for immigrants and addressing rural health grants. Iowa and Wisconsin reported on concerning "conscience rights" legislation and the proliferation of nurse practitioner prescribing practices without sufficient physician oversight.
The Institute featured two keynote speakers who balance medical practices with legislative duties. Both also represent the minority political party in their state.
Rep. William Hauter, MD (R-IL), an anesthesiologist, emphasized the importance of having a "seat at the table." Hauter discussed his efforts to streamline healthcare worker licensing and urged colleagues to build bipartisan relationships to improve physician retention.
Rep. Anita Somani, MD (D-OH), an OBGYN, focused on perinatal mental health. Somani advocated for increased funding for affordable childcare and paid parental leave as essential components of family mental health. She also touched on the modern classroom, supporting efforts to restrict cell phone use in schools to protect student well-being.
The meeting concluded with the formal adoption of three legislative priorities for the coming year:
Encouraging state branch legislative/government affairs leaders to attending the 2027 Legislative Institute.
Improving access to safe care, specifically through the expansion of Collaborative Care Models and opposing unsafe prescribing practices by non- physician providers.
Establishing guardrails for AI, with a specific focus on securing patient privacy when using "ambient AI" during clinical encounters.