Congress Approves Additional Health Care Reform Provisions

Congress has passed and President Obama has signed legislation that modifies the recently enacted health care reform measure. The new bill includes a provision requiring Medicaid to pay primary care physicians at 100 percent of the Medicare rate in 2013 and 2014.

The Health Care and Education Reconciliation Act, or H.R. 4872, (55-page PDF; About PDFs) also expands and strengthens the federal Pell grant program and caps annual student loan repayments at 10 percent of discretionary income for eligible new borrowers, provisions that should ultimately increase the number of primary care physicians, according to AAFP President Lori Heim, M.D., of Vass, N.C.

"It increases loan forgiveness and loan repayment for medical students," said Heim in an interview with AAFP News Now. "We think that is going to help increase the numbers of primary care physicians."

Heim described the reconciliation and health care reform bills as a "very good platform to go forward from."

"But if we stop with just the provisions that are in the bills, it will be insufficient to grow the number of primary care physicians that we need," said Heim.

For example, the provision in the reconciliation bill requiring Medicaid to pay primary care physicians at the same rate as Medicare for primary care services should be extended beyond 2014, said Heim.

The recently enacted health care reform legislation expands Medicaid eligibility to 133 percent of poverty for all nonelderly individuals, a provision that is likely to increase the number of Medicaid recipients, according to Heim. "It doesn't make sense to increase the number of Medicaid eligible patients but to then allow Medicaid rates to go down to the point where physicians will not be able to care for those patients," she noted.