Legislation Could Strengthen Primary Care Workforce to Prepare for Health Care Reform

Sen. Bernie Sanders, I-Vt., and House Majority Whip James Clyburn, D-S.C., have introduced the Access for All America Act (at the THOMAS Web site, type "S. 486" in the search box after selecting "Bill Number"), a bill that would provide funding increases for the nation's community health centers, or CHCs, and the National Health Service Corps, or NHSC. If enacted, the legislation could strengthen and expand the nation's primary care infrastructure to accommodate health care reform efforts and meet the nation's growing need for primary care services, according to Dan Hawkins, policy director for the National Association of Community Health Centers, or NACHC.

"Health care reform is trying to get as close to universal coverage as possible," Hawkins told AAFP News Now. "But coverage is just a vital first step. You also have to build care delivery systems to get care to the people who need it the most. This is a necessary complement to the health care expansions contemplated under health reform, and it therefore has to take place at the same time."

The legislation would increase funding for CHCs from $2 billion to $8.3 billion during a five-year period, thus expanding the number of people who receive services from the centers from 18 million to 60 million, according to a summary of the bill released by Sanders' office. The legislation would increase the number of CHCs from 1,100 facilities to 4,800 facilities by 2015, which is enough of an increase to virtually eliminate federally designated medically underserved areas, says the summary.

The bill also would increase the number of primary care health professionals supported by the NHSC from 4,000 to 28,000 during the five-year period.

The legislation seeks to build on the recently enacted economic recovery legislation, which provides $2 billion in one-time funding for CHCs and another $300 million for the NHSC. It is based, in large part, on an Access for All America Plan proposed last year by the NACHC, which calls for expanding CHC coverage by 2022 to 56 million Americans who are considered medically disenfranchised. The Access for All America Act, by contrast, would extend CHC coverage to 60 million people -- including 56 million Americans who are considered medically disenfranchised -- by 2015.