Primary Care Priorities Included in Infrastructure, Reconciliation Bills; Timing and Outcome is Uncertain

At the time of writing, the fate of the U.S. House of Representatives’ reconciliation package is uncertain. The timing and outcome of a promised House vote on the Senate-passed bipartisan infrastructure bill, the Infrastructure Investment and Jobs Act (IIJA), also remains unclear. Together, the bills could have significant impacts for the under-resourced primary care delivery system. 

Primary Care Provisions in the Reconciliation and Infrastructure Bills 

The reconciliation bill, the Build Back Better Act, includes investments that could shape the future of primary care, with a clear focus on communities facing health inequities. Provisions include: 

  • $10 billion in funding for Community Health Center capital projects 

  • Workforce investments including $6 billion in funding for Teaching Health Center Graduate Medical Education and $1.3 billion for nursing education and loan repayment 

  • A new Medicare dental benefit, inclusive of preventive, minor and major dental care as well as dentures, scheduled for 2028 

The IIJA includes $65 billion to expand broadband access and increase affordability of broadband services for low-income families – improvements with the potential to increase access to digitally-enabled primary care. 

Although the bipartisan IIJA has passed the Senate, the larger reconciliation bill has yet to see Senate mark-up or floor action – where changes to both detailed provisions and overall size of the package are possible. The ultimate fate of its primary care-relevant provisions hinges on unanimous support of the legislation across all 50 members of the Senate’s Democratic majority. 

Medicaid Pay Parity, Medicare Telehealth Await Future Legislative Vehicles 

Two other top PCC policy aims - Medicaid primary care pay parity and Medicare telehealth reforms - remain largely unaddressed by the infrastructure and reconciliation bills. PCC proudly supports the Kids Access to Primary Care Act and the CONNECT for Health Act. Working with its Executive Members, PCC will be pressing Congress for action on these issues. 

Behavioral Health Integration Legislation Possible this Congress 

Exacerbated by the pandemic and associated economic disruptions, the prevalence of substance use disorders and mental health disorders is growing, particularly in communities of color. The Senate Finance Committee is moving toward a legislative package during this congress. Meanwhile, House legislators have introduced a variety of bills that may move independently or as part of an evolving bipartisan CURES 2.0 package

PCC’s Behavioral Health Integration Workgroup is developing federal policy recommendations to advance behavioral health integration in federal payment models. Workgroup meetings occur bimonthly and are open to all PCC Executive Members. To ensure your organization is represented, please contact PCC’s Policy Director, Larry McNeely, at [email protected].  

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