The Aeromedical Certification Coalition
Cleared to Fly
Medical certification is now the bottleneck between a trained pilot and a working one. We're organizing the industry to fix it.
The problem
Every operator feels it, and no one is organized to fix it.
Pilots grounded for months
Special issuance decisions drag on, often for routine, well-controlled conditions and medications. The FAA's own rulemaking committee found about 20% of pilots and controllers who report a mental health diagnosis are initially disqualified, yet fewer than 1% are ultimately denied.
A system that punishes honesty
Pilots and controllers who disclose treatment risk their careers, so many don't seek care. That is the real safety risk.
Long waits
Pilots can wait months just to see an FAA-recognized specialist, and FAA medical review hasn't kept pace with demand.
Costs that land on operators
Lost duty days, stalled upgrades, training seats that never convert, and pilots who leave the profession.
Why now
Congress just proved this issue can move. On September 25, 2026, the Senate unanimously passed the John A. Hauser Mental Health in Aviation Act (S. 3257) and the Aviation Medication Transparency Act (S. 3258). The House passed its own mental health bill (H.R. 2591) in 2025, and its Transportation and Infrastructure Committee advanced the medication bill (H.R. 2592) in September.
The clock is real. If the House does not finish before the 119th Congress ends on January 3, 2027, both bills must start over. Either way, the next 24 months decide whether these reforms change anything on the ground, and whether the broader certification system gets fixed alongside them.
- 1Final House action before the 119th Congress ends
- 2FAA rulemaking and guidance
- 3FY2028 appropriations and the next FAA reauthorization
- 4Oversight
The industry that wins implementation is the one that shows up organized.
The agenda
Three tiers, sequenced so early wins build the credibility for the longer work.
Finish and implement
- Send the Hauser Mental Health in Aviation Act and the Aviation Medication Transparency Act to the President, and carry them into the next Congress if needed
- Track every FAA milestone, comment on rulemaking, and press for on-time delivery
- Secure FY2028 funding and report language for FAA aeromedical staffing and examiner capacity
- Shape the next FAA reauthorization so implementation gaps and Section 411 working group recommendations become law
Fix the pipeline
- Faster, more predictable special issuance decisions, with FAA publishing processing times
- Updated policies on sleep apnea, color vision and common medications, through the FAA's Section 411 Aeromedical Innovation and Modernization Working Group
- More examiner capacity, telehealth exams where appropriate, and a modernized medical portal under Section 413
- Clear, fair treatment of veterans with VA disability ratings entering civilian aviation
- Funding and legal protection for peer support and pilot treatment programs
Build the future
- Certification capacity for the new pilot workforce advanced air mobility will need
- Funding for aeromedical research so FAA policy rests on current evidence
- International coordination on aeromedical standards
- Independent review of FAA aeromedical performance, including GAO studies of decision times and outcomes
Members also receive a monthly aeromedical policy brief, early warning on changes that affect hiring and operations, and coalition data on what certification delays are costing the industry.
Why join
Pilot medicals are an operational risk you can't manage alone.
Cleared to Fly helps you manage it today and fix it for good.
Manage it now
- Priority aeromedical guidance for your pilots through our advisory partner
- A chief pilot and HR playbook for supporting a pilot through special issuance and back to duty
- Quarterly sessions with experienced aviation medical examiners
See it coming
- Early warning on FAA aeromedical policy changes before they hit hiring or scheduling
- A live tracker of every FAA deadline in the new aeromedical laws
- The coalition's annual cost-of-delay benchmark: members get the full data, the public gets the summary
Fix it for good
- A voice in FAA rulemaking and the Section 411 working group
- Direct input on FY2028 appropriations and the next FAA reauthorization
- Your name behind coalition letters, testimony and Hill meetings
Every policy win helps the whole industry. Members get the tools, the intelligence and the seat at the table.
What does one grounded pilot cost you?
Estimated cost of one grounding:
$210,000
Defaults are illustrative. Enter your own numbers.
Talk to us about your numbers
Issue areas
The coalition works on any federal policy affecting the medical certification, health and fitness for duty of pilots and other safety-sensitive aviation professionals.
How new issues get added
- 1Any member can propose an issue
- 2The steering committee adds it by consensus
- 3The full agenda is reviewed twice a year
Issues outside this scope, such as pilot retirement age and BasicMed, stay with members and their associations unless members agree otherwise.
Why a coalition
Aeromedical policy touches every corner of aviation, but it is no one's full-time job. Associations carry it as one line among dozens. Operators feel the pain but have no voice in Washington on it.
A dedicated coalition fills that gap without competing with anyone. It amplifies member associations rather than replacing them, and gives operators, schools and medical providers a seat they don't have today.
What members get
The problem you feel
Pilots grounded mid-schedule; lost duty days.
What the coalition delivers
Faster certification decisions and fewer surprise groundings.
What the coalition delivers in year one
Q4 2026
Founding roundtable sets priorities; full push to finish both aeromedical bills before the 119th Congress ends
Q1 2027
First cost-of-delay member survey; coalition priorities filed for FY2028 appropriations; reintroduction strategy if the bills need it
Q2 2027
First FAA rulemaking comments; member playbook released; first benchmark report
Q3 2027
Coalition recommendations submitted for the next FAA reauthorization
Ongoing
Monthly policy brief, FAA milestone tracking, Hill and FAA meetings
How it's structured
Lean, member-directed and built to keep costs low.
Founding Member
Founding terms locked for 2 yearsFor operators, carriers, advanced air mobility companies, and unions that want a steering committee vote.
- Vote on the steering committee, including the agenda and new issues
- Named in all coalition letters, testimony and press
- Quarterly one-on-one strategy sessions
- Founding terms locked for two years for members who join by the founding roundtable
- Priority aeromedical guidance for your pilots through our advisory partner
- Full benchmark data and a custom cost-of-delay readout for your organization
Member
For mid-size operators and training providers.
- Monthly coalition calls and the policy brief
- Sign-on to coalition positions
- Invitations to Hill and FAA meetings on member issues
- Chief pilot and HR playbook
- Full benchmark data
Associate
For flight schools, universities, AME practices, peer-support groups and aeromedical providers.
- Monthly policy brief and quarterly calls
- Name on coalition sign-on letters
- Benchmark summary and the member playbook
Association & Union Council
For national aviation associations and labor unions.
- Government affairs leads review coalition positions before they're taken
- Opt out of any position at any time
- Named on every priority you endorse, with full credit for your own advocacy
- Engage only on the issues that matter to your members, such as mental health and medication policy
- Your existing channels with the FAA stay yours; the coalition supports them and never speaks for your members without approval
- Coalition data available for your own advocacy, with credit
The coalition takes positions only where members agree. No member is ever committed to a position it hasn't approved.
Membership details available on request.
Who leads it
Austin O'Boyle
Chief Lobbyist, Pilot Mental Health Campaign
Austin ran the federal strategy behind the John A. Hauser Mental Health in Aviation Act and the Aviation Medication Transparency Act. He helped lead the informal industry coalition of pilot groups, unions, associations and advocates that backed both bills. The House passed the mental health bill unanimously in September 2025. The Senate passed both bills unanimously in September 2026.
- Helped lead the informal industry coalition that backed both bills
- Ran Hill strategy for both aeromedical bills in the House and Senate
- Secured $3 million a year for the FAA Office of Aerospace Medicine
- Relationships across the offices and committees that will shape implementation, FY2028 appropriations and the next FAA reauthorization
- Multiple-time Top Lobbyist honoree (The Hill; National Institute for Lobbying & Ethics)
"These bills passed because a lot of organizations pulled in the same direction. Cleared to Fly exists to keep them pulling together."
November · One hour
Join the founding roundtable
A one-hour working session in November to set the coalition's first-year priorities. No commitment to join.