Potential Wins Seen as Congress Ponders Reconciliation

The AAFP’s Sept. 23 letter, sent to Senate Majority Leader Chuck Schumer, D-N.Y., and House Speaker Nancy Pelosi, D-Calif., analyzed the House reconciliation bill and outlined a number of sections important to family physicians and their patients.

“If enacted, these provisions will invest in the primary care workforce, improve health equity, increase access to health coverage, address vaccine confidence and strengthen our public health infrastructure,” said the letter, signed by (then) Board Chair Gary LeRoy, M.D., of Dayton, Ohio.

Among the reconciliation bill’s allocation and guidance drawing the Academy’s strong support are

• $6 billion for the Teaching Health Center Graduate Medical Education Program and improvements to the THC infrastructure, funding for which the AAFP has long advocated;
• $10 billion for capital improvements to community health centers, where some 29 million Americans receive care;
• creation of the Pathway to Practice Training Program, which, the letter noted, “would help diversity and strengthen the physician pipeline by providing scholarships to underrepresented and economically disadvantaged students;”
• 1,000 new graduate medical education slots for Pathway students, beginning in 2027;
• continued enhanced subsidies for the Patient Protection and Affordable Care Act marketplace established in the American Rescue Plan;
• coverage for low-income individuals in states that have not expanded Medicaid under the ACA;
• Medicaid coverage for incarcerated individuals to automatically begin 30 days prior to their release, policy the Academy has supported;
• permanent expansion of the Children’s Health Insurance Program, which covers about 8 million children;
• one-year postpartum Medicaid coverage for mothers;
• $1 billion in funding for programs included in the Black Maternal Health Momnibus Act of 2021, which the AAFP supports as a key to addressing the U.S. maternal health crisis;
• $7 billion in public health infrastructure spending through grants to state and local health departments, in line with Academy policy;
• $1.25 billion to increase vaccine confidence and improve rates of routine vaccinations; and
• an increase of the federal tax on cigarettes to $2.01 per pack (which the Academy last month, as part of a coalition, said was among several overdue adjustments to federal policy).

Congress’ work on reconciliation is expected to take several months.