• In The Trenches

    Dollars and Sense: Budget Resolution Addresses AAFP Priorities

    Sometimes commentators say that some political change or government expenditure is “sweeping” when what they’re describing is simply and unpoetically big.

    Capitol building

    Other times, however, the dramatic flourish is well earned — for example, the $3.5 trillion fiscal year 2022 budget resolution that Senate Democrats passed Aug. 9, designed to enact much of President Joe Biden’s American Families Plan (which the AAFP supports).  

    The Biden administration summarizes the budget’s aims as “human infrastructure”: funds for housing, job training, and family and medical leave, as well as farsighted, education-minded investments, including universal pre-kindergarten and two years of tuition-free community college. I’d say a number of these elements can be filed under a heading more familiar to Academy members: “social determinants of health.” The resolution’s attention to these issues alone makes it of powerful interest to the Academy.

    Beyond that, though, it would expand subsidies in the Patient Protection and Affordable Care Act, fill the Medicaid coverage gap and devote resources to home and community-based health care.

    So yes, from the AAFP’s perspective, this resolution absolutely sweeps.

    Three trillion doesn’t swoosh out of the soft-serve machine without some fine print and, later, some debate. The resolution directs committees in the Senate and the House to spell out what, how, how much and how to pay for it all. A separate battle looms over increasing the federal debt limit before Oct. 1.

    By that deadline, we may all be tired of whatever theatrics accompany the budget conversation. But what’s at stake is a historic expansion of the social safety net that also reinforces the parts of it that intersect with family medicine, from the practice level on up to the future of the specialty’s workforce.

    Besides the resolution’s ACA fortification, we’re monitoring a number of its aims, including planned investments in

    • addressing health professional shortages through action on graduate medical education;
    • Medicare expansion to cover hearing, dental and vision benefits, and lowering the eligibility age;
    • health equity;
    • maternal mortality; and
    • workforce building blocks such as community health centers, the National Health Service Corps and the Teaching Health Center Graduate Medical Education program.

    Physicians’ Welfare

    The Senate recently passed the Dr. Lorna Breen Health Care Provider Protection Act (S. 610), legislation the Academy has endorsed. When the House ends its recess, its agenda will be very full. Passing this should be on it.

    S. 610 is named for an emergency physician who died by suicide after an intense front-line fight to save patients during the pandemic’s harrowing early days. The legislation would address suicide and burnout among health care professionals; it also calls for study into related concerns, such as the stigma of seeking help.

    The need has rarely been more stark. As we said in our letter supporting the legislation, the American Board of Family Medicine reports that primary care physicians have experienced the highest rate of death — 26.9% — among medical specialties during the pandemic. According to a January 2021 report, 47% percent of family physicians reported feeling burned out, and 20% of all physicians said they were clinically depressed.

    Those are grim numbers. The House should embrace this opportunity to keep them from getting even worse.

    Stephanie Quinn is senior vice president of advocacy, practice advancement and policy.


    Stephanie Quinn, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.  Read author bio »


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