ACA Champions H.R. 7157; ICA Voices Major Concerns
Dynamic Chiropractic Staff
| DIGITAL EXCLUSIVE
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations – to Congress urging swift passage of the Chiropractic Patients' Freedom of Choice Act of 2018, the International Chiropractors Association is "urging caution" on H.R. 7157 based on the language of the bill being "incongruent with promises made." Specific ICA concerns include the following:
HR 7157 inserts a 'qualifier' which will set the entire profession up to become 'aberrant billers'. Rather than leave the "manual manipulation of the spine to correct a subluxation" intact, the language included in the statement of purpose will become part of the notes section of the law and inserts "as demonstrated to exist" as a new, unnecessary and arbitrary qualifier for compensation not required of any other physician level provider.
[HR 7157] includes a provision to limit services reimbursed by chiropractors, who are determined to be aberrant billers on a quarterly basis. In essence, the promised expansion of coverage will be eliminated for anyone the Centers for Medicare and Medicare Services (CMS) determines to be over billing. This is a provision ripe for abuse by over-zealous Medicare administrators.
All important decisions on coverage specifics, including dates and timelines, are at the discretion of CMS personnel. As written, CMS may drag out the implementation for 3-5 years.
HR 7157 also ignores the request of the chiropractic community to be treated equally in Section 1395a of the Social Security Act provision on private contracting.
In its press release, the ICA concluded: "HR 7157 provides no guarantee that any expanded compensation will be provided in the near future. As currently written the ICA does not support HR 7157 and recommends caution to the profession regarding the language in the legislation. The ICA is in the final stages of crafting legislation that is practical, feasible and has a realistic prospect of passage."
Building on a historic March 2026 meeting between Make America Healthy Again and chiropractic leadership, MAHA has announced the launch of the MAHA Chiropractic Hub, “a coordinated national partnership uniting MAHA Center, MAHA Action, and the chiropractic profession, including national associations, state organizations, practitioners, educators, researchers, and patient advocates. The Chiropractic Hub will advance federal policy, expand patient access, and build broad public support for chiropractic care across America.”
The chiropractic profession is confronting one of the most significant federal regulatory threats it has faced in decades. A new U.S. Department of Education (ED) accountability framework – commonly referred to as the “Do No Harm” (DNH) regulation – could place many chiropractic programs at risk of losing access to federal financial aid (student loans), potentially reshaping the future of chiropractic education and workforce development across the United States.
Pain has become the dominant language of musculoskeletal healthcare. Numeric pain-rating scales and symptom reports are routinely used as primary indicators of clinical success. But while pain reduction is meaningful, it is an incomplete and often misleading representation of recovery. This has real consequences for patient adherence, long-term outcomes, and how conservative care is perceived within the broader healthcare system.
