Headache on the Hill: Nan Cheng, MD, Advocates for Migraine Patients in Washington, DC

On Feb. 10, 2026, Nan Cheng, MD, was in Washington, DC, to advocate for the estimated 40 million Americans suffering from migraines and other headache disorders. As an assistant professor of neurology in the UC Irvine School of Medicine, she was one of 300 individuals — including patients, caregivers, clinicians and researchers — to attend Headache on the Hill, a bi-annual event organized by the Alliance for Headache Disorders Advocacy (AHDA).

“I was invited to be a panelist for the Capitol Hill Policy Forum, a congressional briefing during which I provided a clinical perspective on the burden of migraine and other headache disorders,” says Cheng, noting that the financial cost of migraines in the U.S. is $78 billion annually. “Headache care is very reactive. We’re waiting to have patients go to the ER or go on disability, and there’s a huge loss in productivity. We need to be more preventative.”

Cheng, whose latest research explores how to lessen the pain of Botox treatments for patients with chronic migraine, has been attending Headache on the Hill for several years. Each trip, the AHDA has a series of requests, and this time advocates asked members of Congress to cosponsor the following:

• the HEADACHE Act, establishing a national strategy to coordinate headache research, expand access to specialty care and address stigma surrounding headache disorders;
• the Safe Step Act, removing insurance-related requirements that can delay treatment access; and
• the CONNECT for Health Act, making permanent many of the telehealth options implemented during the COVID-19 pandemic.

Cheng encouraged support from California Representatives Dave Min, Young Kim, Lou Correa and Lateefah Simon, outlining the benefits for millions of Americans.

“The HEADACHE Act is the first legislation to address headache-related disorders,” says Cheng. By creating a National Headache Disorders Initiative within the Department of Health and Human Services, it would help coordinate existing efforts and promote research. “It’s basically a national plan for how we want to treat this disorder, with more data sharing within federal organizations,” says Cheng. She hopes it will lead to more funding for research into preventative treatments.

The Safe Step Act addresses “step therapy,” or the “fail-first requirement” of health insurers who deny coverage for a prescribed treatment unless an alternative insurer-preferred treatment is tried first. Patients with headache disorders are among those most impacted by these protocols. “This is a very time-consuming and non-streamlined process, and sometimes patients have to take medications they’ve already tried if they switch insurance,” says Cheng. “Safe Step creates guardrails by creating a clear exemption process.”

The CONNECT Act would make telehealth permanent for Medicare patients, giving patients easier access to headache specialists. “Currently, telehealth is tied to the budget, so every time there’s a government shutdown, you lose access,” says Cheng. “It really catches patients by surprise.” She says the statistic that really hits home with members of Congress is that there are fewer than 1,000 certified headache specialists in the U.S. “There’s around one specialist for every 40,000 patients,” says Cheng. “We need a more coordinated effort for providing timely access to specialized care.”

When meeting with representatives and speaking during the policy forum, Cheng addressed misinformation and stigma around headache disorders. “I discussed how underdiagnosis, prior authorization, step therapy and workforce shortages directly affect patient outcomes and highlighted the need for coordinated federal action to improve research investment, training pipelines and access to evidence-based care,” she says. “We need to use our voice to advocate for the patients who can’t attend, because migraines are so debilitating.”

You can contact your Senators and House Representative about their support for the HEADACHE Act.