The Senate Health, Education, Labor and Pensions Committee on Thursday advanced bipartisan legislation that would invest more than $26 billion in primary health care. However, it remains unclear if the bill has the necessary support to pass the full Senate, especially before current funding expires on September 30.
“We have a major, major crisis in primary health care which is getting worse every day,” Sen. Sanders said in his announcement, describing health worker shortages that negatively impact patients’ access to care.
The Bipartisan Primary Care and Health Workforce Act bill would boost funding for community health centers from $4 billion to $5.8 billion per year for three years. The funding would go toward expanding hours of operation at community health centers and school-based health services. It also includes funding for scholarships and debt forgiveness for medical professionals, as well as new primary care residency slots and more funding for nursing training programs.
“It is a far more modest piece of legislation than I would have liked to have seen,” committee Chairman Bernie Sanders, I-Vt., said. “But if this legislation is passed, it will not only save us substantial sums of money by making our health care system more efficient and rational, but it will go a long way toward making primary health care in America more affordable and accessible for millions of Americans.”
All Democrats on the committee voted for the bill and were joined by cosponsor Dr. Roger Marshall, D-Kan.; Lisa Murkowski, R-Alaska; and Sen. Mike Braun, R-Ind. However, another Republican, Sen. Bill Cassidy of Louisiana, voiced strong opposition. Cassidy said he tried to negotiate with Sanders but that the chairman wanted an unrealistic amount of money for health centers that wasn’t going to be offset. Cassidy filed 67 amendments, although he withdrew all of them and called for votes on only four of them.
“If you want to do something positive for patients, then actually do the work to find the offsets on a bipartisan, bicameral basis,” he said. “Don’t just say someone else will figure it out. If you don’t pay for it, then all you have is a messaging bill. That is cynical. It is manipulative.”
Sanders and Marshall said the bill will be fully paid for with about $10 billion from bills in the committee’s jurisdiction and “assurances” from other panels about being able to use additional bills outside its jurisdiction. There is no independent estimate on how much the bill could cost.
The bill also includes measures targeting hospital billing practices, which drew the ire of groups such as the American Hospital Association and the Federation of American Hospitals, which wrote to the committee in opposition. It would ban hospitals from using anticompetitive practices in certain contracts when they negotiate prices with commercial insurance companies and prevent hospitals from charging facility fees for certain services, such as telehealth, that don’t occur on a hospital campus.
Even if the full Senate passes the legislation, it faces an uncertain future. The House Energy and Commerce Committee previously advanced its own version of a community health center funding extension in a unanimous vote. However, it hasn’t been brought to the floor yet, because Republican leaders have not been able to get the caucus to agree on legislation to would fund the government.