ACCMA 2025 Presidential Speech: Dr. Clifford Wong November 11, 2025 From the President Good evening, friends and supporters of the ACCMA. It is my honor and privilege to welcome and address you all at this 157th annual meeting. I embark upon this presidential year bearing in mind our mission to improve the practice of medicine for the benefit of patients and public health. Now more than ever we must be guided by that purpose. It is difficult to foresee the issues and challenges the incoming President will face. Could Dr. Peters & Dr. Dutta have imagined needing to lead us during the COVID pandemic? And now merely a few years later, (Dr.) Lo and behold, could we have imagined the upheaval and uncertainty now threatening our health care system, the looming erosion of our public safety net, and the undermining of public confidence in evidence-based medical practice? This July 4th, our nation received quite the birthday gift in the form of HR1, the One Big Beautiful Bill Act. Beauty is in the eye of the beholder, but from a health care perspective, this one is aesthetically challenged. HR1 has enacted deep cuts to Medicaid and the Affordable Care Act, totaling over $1.2T, representing the largest rollback of federal support for healthcare in American history. An estimated 10M will become uninsured within 10 years, largely due to Medicaid cuts of $990B. Separate from HR1, an additional 5M will lose coverage due to the expiration of ACA enhanced premium tax credits and prior HHS rule changes to the ACA marketplace. What does this mean for CA? 2.5M will lose MediCal & nearly 2M will pay 97% higher premiums or lose coverage. But, friends, that is just the funding rug being pulled out from under us. Complicating matters, we find ourselves on the defensive against an unexpected and insidious attack on science. This is our second year hosting our annual meeting at the Chabot Space and Science Center, and I find it particularly fitting this year that we are gathered in an observatory, an institution of science. In the 17th century, telescopes enabled astronomers to usher their field into a modern era. It was their discoveries that propelled the Scientific Revolution, beginning a period when empiricism, reason, & logic prevailed. Yet here we are today, some 400 years later. And like the astronomers of old, who were challenged, even labeled heretics, for believing the earth revolved around the sun, we the doctors of 2025 are facing unprecedented skepticism and suspicion of the science-based practice of medicine. We are alarmingly witnessing the dismantlement of our public health infrastructure; hurdles to scientific progress created by research funding cuts; leadership and advisory group experts with career experience and scientific training replaced; and heretofore publicly accepted medical guidance on vaccines, pasteurization of milk, even Tylenol, now suddenly put in question. Are we about to enter a Scientific Devolution? Not if we can help it. In the face of these obstacles, the ACCMA supports and defends evidence-based medical practice, advocates for health care access, including reproductive and gender-affirming care, and seeks to protect vulnerable populations. At our recent California Medical Association House of Delegates, our delegation joined our state's sister societies in responding to the damaging effects of HR1 and the assault on science with policy reaffirming these objectives. We also recognize that these federal threats come at a time when medical practices continue to contend with rising operating costs, payments that lag behind the cost of providing care, and administrative burdens, all of which threaten practice viability and jeopardize patient access to care. Your medical association works on your behalf to advocate for prior authorization reform, support telemedicine services, & call for fair reimbursement, including securing our voter-approved Prop 35 funding & inflation-indexed Medicare payments. Before I conclude, I want to take a moment to acknowledge those who've supported me along the way: My partner Alex, my dear friends, my colleagues at St. Rose and Washington Hospitals, and partners at West Coast Kidney Institute. I acknowledge my fellow ACCMA members who have given me the privilege to lead this year and am honored by your confidence. This moment is a critical one. And it is critical for us to pay attention to what is happening, as busy as we may be in our practices. It is critical for us to use our voice to counter those that obfuscate and sow distrust and doubt. It is critical for us to practice as models of reason, logic, and faith in science. A quote attributed to the great astronomer Galileo: "It is surely harmful to souls to make it a heresy to believe what is proved." Stand by what is proved. And be proud to represent science and our profession.