The Michigan State Medical Society (MSMS) Health Policy Fellowship continues to attract outstanding medical students who are passionate about patient care, healthy communities, and learning how legislative, regulatory, and payer policies impact the practice of medicine. Fellows spend four weeks working with MSMS Advocacy staff on various timely issues of importance to physicians. This fall, MSMS hosted two students, Harsna Chahal, MPH, and Husna Hussaini. Below are their reflections about their experiences at MSMS.
Harsna Chahal, MPH:
As a third-year medical student at the Central Michigan University College of Medicine, I completed a health policy internship with the Michigan State Medical Society (MSMS). Having previously been involved in public health and advocacy initiatives, I was excited to learn more about the work being done at MSMS and how physicians can play a role in shaping healthcare policy.
During my time at MSMS, I worked on a variety of policy issues, including Medicare physician reimbursement, primary care payment reform, maternity care coding and reimbursement, and continuing medical education (CME) requirements. I researched proposed legislation, reviewed policy changes, and developed materials to support MSMS's advocacy efforts. I also learned more about the Patients First Act, the proposed 2027 Medicare Physician Fee Schedule, and the ongoing efforts to reduce unnecessary administrative burdens on physicians. These projects helped me better understand the challenges physicians currently face and the work it takes to advocate for meaningful policy changes.
One of the projects I was most passionate about was helping draft advocacy letters on behalf of MSMS to the Centers for Medicare & Medicaid Services (CMS) and the Michigan Department of Health and Human Services (MDHHS), which oversees Michigan Medicaid, regarding proposed changes to maternity care coding and reimbursement. Given my interest in pursuing obstetrics and gynecology, it was especially enriching to contribute to a policy issue directly related to my future specialty. Our letters supported the transition to updated maternity care coding beginning in 2027, while also raising concerns about maintaining competing billing systems, limiting reimbursement for medically necessary prenatal and postpartum visits, and imposing prior authorization requirements. We emphasized the importance of allowing physicians to provide individualized maternity care, especially for patients with high-risk pregnancies who may require additional monitoring and follow-up. It was rewarding to see how the clinical concerns I have been learning about during my clerkship rotation could be incorporated into policy recommendations at both the state and federal levels.
Outside of these projects, I attended several meetings and conferences, including End Race-Based Medicine advocacy meetings, a Michigan Doctors’ Political Action Committee (MDPAC) meeting, the MSMS Committee on State Legislation and Regulations, the Healthcare Information and Management Systems Society (HIMSS) Fall Conference, and the Physician Group Incentive Program (PGIP) Triannual Meeting. I also attended Michigan House Health Policy Committee hearings, where I saw firsthand how legislation is discussed and how different organizations and healthcare professionals advocate for issues directly affecting Michigan residents. One of my favorite parts of this experience was hearing directly from physicians and other healthcare leaders about the challenges they face and the work they are doing to address them.
One of my biggest takeaways from this internship was recognizing how much medicine is shaped by decisions made outside the hospital or clinic. As medical students, we spend an abundance of time learning to care for patients. However, we don't always get to see how healthcare policy shapes our future practice. This experience helped me better understand the importance of physician advocacy and why medical students and residents should join these conversations early on. It also reinforced my interest in continuing to advocate for maternal health, health equity, and policies that support both current and future physicians.
I am incredibly grateful to the entire MSMS team for welcoming me and allowing me to be part of the work they do every day. I learned so much during my time here, and I truly appreciate the mentorship, conversations, and opportunities I was given. I hope to stay involved with MSMS throughout medical school and beyond, especially in maternal health, medical student advocacy, and legislation and regulations. I also encourage other medical students and residents to get involved with MSMS, as these opportunities offer much to learn and give students a firsthand look at the impact physician advocacy can have.
Husna Hussaini:
Before entering the Michigan State Medical Society (MSMS) Health Policy Fellowship, I had encountered healthcare policy through a different lens: journalism. As a radio host and news correspondent in Champaign, Illinois, I covered developing stories about healthcare access and health policy, learning to investigate complex decisions and communicate their consequences to the public. Yet reporting on these issues was different from understanding how physicians could help shape the decisions themselves. As a third-year medical student, much of my education has centered on diagnosing and treating the patient in front of me. I entered this elective hoping to connect my experiences in journalism and medicine and better understand the systems determining whether patients can access care and physicians can sustainably provide it.
Through the MSMS Health Policy Fellowship, my legislative research moved me from reporting on policy to examining the decisions behind it. I examined Michigan bills addressing healthcare professionals' title transparency and artificial intelligence in insurance decisions, as well as possible protections requiring advance notice of payer policy changes that could financially affect medical practices. I also researched proposed changes to Accreditation Council for Graduate Medical Education (ACGME) resident duty-hour requirements, comparing legislative language and medical society positions across states and organizing findings into research grids. Rather than simply deciding whether I supported an idea, I learned to examine its specific language, supporting evidence, and potential unintended consequences. A proposal intended to reduce administrative burdens, for example, might also raise questions about accountability, patient safety, or how physicians are trained.
Attending the Health Care Delivery Committee meeting showed me how this analysis becomes organizational action. Watching physicians consider proposals and resolutions, exchange differing perspectives, and vote on recommendations illustrates that advocacy requires more than a strongly held opinion. Members had to weigh how a policy might affect physician autonomy and practice viability while also considering patients, affordability, and the broader healthcare landscape. The Board of Directors meeting added another dimension, illustrating how financial decisions, membership priorities, and long-term organizational sustainability shape a medical society's ability to advocate effectively. I came to appreciate that thoughtful governance is itself a form of service to physicians and patients.
Other opportunities showed me how policy becomes operational reality. With the Blue Cross Blue Shield of Michigan Tri-Staff, discussions included prospective primary care payment models, maternity billing, incident-to billing, and payment delays. With the Saginaw and Genesee County medical society office managers, I saw why these seemingly technical changes matter to those running medical practices. A reimbursement adjustment or poorly communicated policy change can affect staffing, administrative workload, and ultimately the availability of appointments. These experiences made clear that payment policy is not separate from patient care. Rather, it helps determine the resources available to deliver it.
The Medicaid Coverage Workgroup and Michigan Multipayer Initiatives Steering Committee broadened that perspective further. Discussions of Medicaid work requirements, more frequent eligibility reviews, and coverage transitions raised concerns about patients who may remain medically vulnerable even when their insurance status changes. The multipayer discussions emphasized strengthening primary care, ensuring that increased investment actually reaches frontline practices, and using all-payer claims data to improve transparency and policy decisions. I began to see that expanding access requires more than announcing new funding or coverage rules: implementation must be practical for patients and clinicians alike.
Observing the Medical Malpractice Coalition illustrated the difficult balance between competing legitimate interests. Discussions of introduced bills, court cases, possible liability reforms, and the need for specialty and region-specific data prompted me to consider both fair compensation for injured patients and the effects of malpractice costs on physicians and access to services. I learned why evidence, coalition-building, and careful legislative language matter, particularly when the consequences of a policy may differ across communities.
A meaningful experience was meeting elected officials at a legislative reception and hearing from Representative Matt Longjohn, MD, during the multipayer meeting. Speaking with a physician whose commitment to improving healthcare led him into government introduced me to a path I had not seriously considered: physicians can influence patients' lives not only through clinical care or professional advocacy, but also by serving as lawmakers. In many ways, the fellowship brought my journalism background full circle. I once reported on decisions affecting healthcare; now I better understand how physicians can participate in shaping those decisions, weigh competing perspectives, and advocate for meaningful change. I leave more committed to becoming a physician who understands policy, asks whose voices and interests are missing, and works to strengthen both medical practice and the health of the communities we serve.
MSMS thanks Ms. Chahal and Ms. Hussaini for their contributions during their fellowships and commitment to medical service.
For further information, please contact MSMS Chief Operating Officer, Rebecca J. Blake at 517-336-5729 or rblake@msms.org.