Hill Update: What Health Centers Need to Know

Two key House Committees took action earlier this week on the legislation that significantly boosts investments for health centers as part of the broader $3.5 trillion Build Back Better Act. This is the administration’s social infrastructure plan that we’ve been reading about. NACHC’s Public Policy and Research division is actively monitoring and providing feedback to policymakers about this important legislation. We’re also encouraging all in the health center community to take action to ensure that our voice is being heard on this important bill. Below is a summary of the bill’s highlights:

Health Center Capital & Workforce Funding
NACHC has been pushing for investments for health center capital projects and increased primary care workforce funding. Both priorities are included in the Energy & Commerce Committee version of the bill and include critical funding to renovate, repair and build new health centers, and money to expand the primary care workforce:

• $10 billion allocation for infrastructure funding for Community Health Centers and Look-Alikes
• $6 billion allocation for the Teaching Health Center Graduate Medical Education program and $500 million allocation for Teaching Health Center capital
• $300 million allocation for the Nurse Corps. Loan Repayment program

Policies that Impact Medicaid, Medicare and the Affordable Care Act
The House Energy and Commerce and Ways and Means Committees approved a raft of measures that would expand Medicaid coverage and bring long-needed stability to the ACA marketplace. This is good news for health center patients, approximately half of whom are on Medicaid, and many are uninsured or rely on the Affordable Care Act (ACA) marketplace for private coverage. In the twelve states without the Medicaid expansion, more than two million people fall in the “coverage gap.”

The comprehensive package of Medicaid reforms – closing the coverage gap to help cover millions living in non-expansion states; permanently extending the Children’s Health Insurance Plan (CHIP); establishing 12-month postpartum coverage for mothers and 12-month continuous eligibility for children; and permanently extending express lane eligibility for children, among others – will strengthen the ability of health centers to continue providing the primary care and prevention services for patients.

The important thing to know is these reforms create a bridge to coverage for people in non-expansion states and extend or make permanent key provisions that improve the value of ACA coverage. People who live in non-expansion states who fall in the coverage gap will have access to more affordable health insurance coverage and subsidies to make it more affordable for consumers.

Finally, for the vast majority of health centers across the country that provide dental services – and many provide vision services as well – there is at long last Medicare coverage for dental, hearing and vision care. Medicare enrollees will have access to a dental benefit beginning in 2028, which will cover preventive care and basic and major treatments by both dentists and other mid-level oral health professionals. The Medicare vision benefit will begin in 2022 and covers routine eye exams, eyeglasses and contact lenses. The Medicare hearing benefit will begin in 2023, and covers hearing aids and related care.

Taken together, these provisions will have a sizable impact on health centers and their patients, which is why NACHC is focused on making sure health centers are adequately reimbursed when they provide these services.

Drug-Pricing Provisions
Lowering the price of prescription drugs is a key goal for this legislation for Congressional leadership and the Biden administration. The legislation would do that through a variety of policy changes that include mandating the Secretary of Health and Human Services to negotiate directly with drug manufacturers and establishing mandatory rebates for drug manufacturers for certain Medicare Part B and Part D drugs with prices that are increasing faster than inflation. NACHC staff is monitoring a number of provisions for the potential downstream impacts to the 340B program.

How You Can Advocate for Community Health Centers
The Build Back Better Act could be as large as $3.5 trillion but it is very likely that the overall package will be reduced. As a result, it is critical that the collective voice of the health center community – staff, patients, board members, PCAs and HCCNs – is heard to ensure that the legislation continues to recognize the important role of health centers. All are encouraged to take action via hcadvocacy.org in support of health center capital and workforce funding.

NACHC Policy staffers Deila Davis, Jeremy Crandall, Vacheria Tutson and Joe Dunn contributed to this blog post.