Ensuring Access to Primary Care for Women and Children Act

August 27, 2014

Hon. Patty Murray    Hon. Sherrod Brown 
United States Senate    United States Senate 
154 Russell Senate Office Building    713 Hart Senate Office Building 
Washington, D.C. 20510    Washington, D.C. 20510

RE: Ensuring Access to Primary Care for Women and Children Act

Dear Senators Brown and Murray:

On behalf of the Patient-Centered Primary Care Collaborative (PCPCC), we thank you and cosponsors Sens. John D. Rockefeller (D-WV) and Mary Landrieu (D-LA) for introducing the Ensuring Access to Primary Care for Women and Children Act. The PCPCC supports efforts to strengthen Medicaid and support the now 66  million Americans who rely on it by extending Medicaid parity payments provided in the Affordable Care Act (ACA) through 2016.

Founded in 2006, the PCPCC is dedicated to advancing an effective and efficient health system built on a strong foundation of primary care and the patient-centered medical home (PCMH). Today, PCPCC’s membership represents more than 1,200 medical home stakeholders and supporters throughout the U.S. The PCPCC achieves its mission through the work of our five Stakeholder Centers, led by experts and thought leaders who are dedicated to transforming the U.S. health care system through delivery reform centered on patients and their families, payment reform, patient engagement, and employee benefit redesign. 

Our diverse membership includes the many physicians, nurse practitioners, and other health professionals on the care team who treat the growing number of Medicaid patients. When the Affordable Care Act raised the Medicaid reimbursement rate to match Medicare’s higher rate for calendar years 2013 and 2014, those health care providers -- who as you know treat the poorest of the poor, often for less than the cost of providing that care -- were positively affected.  Research suggests that low reimbursement rates have historically been deterrents for health care providers to accept and treat Medicaid patients. Since October 1, 2013, enrollment in Medicaid increased by more than 7 million Americans and is expected to climb . Even in states that have not yet agreed to expand Medicaid, the number of enrollees has grown by almost 1 million . As Medicaid continues to grow, the demand for primary care will increase as well. The Ensuring Access to Primary Care for Women and Children Act will extend these enhanced reimbursement rates to 2016, allowing the roughly one in five Americans enrolled in the program to continue receiving the care they need. 

In extending the Medicaid parity provision of the ACA, this legislation ensures that Medicaid continues to pay no less than the applicable Medicare rates for primary care services and vaccinations by family physicians, internal medicine physicians, and pediatricians. In addition, we were encouraged that the bill specifically recognizes the important role that physicians who specialize in obstetrics and gynecology (OB/GYN) play in providing primary care services to women of child bearing age. The bill makes OB/GYN physicians eligible for the same enhanced Medicaid payments as the currently eligible specialties if 60% of their services are primary care. Since women comprise over half of the adult Medicaid patient population, this change makes sense for the program and its participating providers. 

As more than 30 years of research demonstrates, primary care services are associated with better outcomes and lower costs. Providing primary care to the most vulnerable patients and their families to prevent unnecessary visits to the emergency room and in-patient hospitalization overall saves money while improving quality of care. By extending and expanding Medicaid parity payments, this legislation highlights the value of high-quality primary care and the positive effect it can have on patients who rely on Medicaid and the health providers who treat them. Thank you for your commitment to improving access to primary care services for those that need it most. 

Should you have any questions, please contact Marci Nielsen, the Chief Executive Officer at the PCPCC at [email protected] or (202) 417-2074.


Marci Nielsen, PhD, MPH
CEO, Patient-Centered Primary Care Collaborative

PDF icon PCPCC Medicaid Parity Letter.pdf291.6 KB
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