ASTRO, along with more than 100 other organizations, sent a letter to Congress welcoming the 118th session and pledging partnership to permanently reform the physician payment system. Signers also urge both the House and Senate to hold Congressional hearings and work with stakeholders to explore long-term payment solutions. Unfortunately, Medicare beneficiaries continue to struggle with access to timely and quality care, which is particularly important for underserved and rural areas. The medical community continues to contend with the residual impacts of the COVID-19 pandemic, record levels of burnout, workforce shortages, and ongoing reductions to both Medicare and private payer reimbursement.