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community health centers
Sanders' Bipartisan Bill to Combat US Primary Care Crisis Passes Key Senate Panel
The HELP Committee chair pledged to work with Senate leadership "in the coming weeks to move this bill forward and ensure that millions more Americans can get the healthcare they deserve."
Sep 21, 2023
U.S. Senate Health, Education, Labor, and Pensions Committee Chair Bernie Sanders celebrated on Thursday after the panel advanced his Bipartisan Primary Care and Health Workforce Act, teeing up a possible full-chamber vote on the bill.
"Everyone in America understands that our healthcare system is broken and getting worse," Sanders (I-Vt.) said in a statement. "Despite spending twice as much per capita as any other nation, millions of Americans are unable to access the primary care and dental care they desperately need and we have a massive shortage of doctors, nurses, dentists, and mental health professionals."
"With today's passage of bipartisan legislation in the Senate HELP Committee, we are beginning to address that crisis," added the senator, a longtime advocate of Medicare for All. "I'm pleased this legislation passed with a strong bipartisan 14-7 vote."
"I especially want to thank Sen. Roger Marshall (R-Kansas) for his hard work on this legislation," he said. "Together, we will work with Senate leadership in the coming weeks to move this bill forward and ensure that millions more Americans can get the healthcare they deserve."
The committee's decision to advance the healthcare bill—and three others, which were agreed to by voice votes—comes just a week after Sanders and Marshall, a physician, announced that they had reached a deal on the "historic" legislation.
The bill, which took months of work, "increases mandatory funding for Federally Qualified Community Health Centers from $4 billion a year to $5.8 billion a year for three years, which will enable more Americans to receive not only high-quality primary healthcare, but dental care, mental health counseling, and low-cost prescription drugs," Sanders told the committee on Thursday.
"What we have in front of us with your vote is the most significant piece of legislation in addressing the primary healthcare crisis in modern American history."
"In addition, this bill includes a one-time allocation of $3 billion to be used to establish dental operatories so that community health centers can expand their dental care capabilities," he continued. "This legislation will save substantial sums of money. Investing in primary healthcare will keep people healthier and out of hospitals; investing in community health centers will keep people out of emergency rooms, which cost about ten times more per visit than a community health center."
Dr. Kyu Rhee, president and CEO of the National Association of Community Health Centers (NACHC), said last week that "health centers appreciate the strong leadership from Chairman Sanders and Sen. Roger Marshall."
"This bill lays out a vision that emphasizes the role of health centers and expands their reach beyond the 31.5 million existing patients," he pointed out. "The bill also encourages much-needed growth of the primary care workforce by investing in innovative health center-led career development programs."
Noting Thursday that Senate HELP Committee Ranking Member Bill Cassidy (R-La.) put forth over five dozen amendments, Sanders said: "Is this a perfect piece of legislation? No, I don't think so."
Yet, Sanders stressed, it also represents a remarkable opportunity.
"As every member of this committee knows, it is very difficult to get any substantive legislation passed in Congress today," he said. "Sen. Marshall and I and other senators have tried, and what we have in front of us with your vote is the most significant piece of legislation in addressing the primary healthcare crisis in modern American history."
The Senate panel's vote for the Bipartisan Primary Care and Health Workforce Act comes as House Republicans are self-destructing, pushing the United States toward a potential government shutdown in just over a week. Unless Congress acts to prevent a shutdown before the end of the month, all federal funding for health centers will expire.
NACHC's Rhee said Monday that "I am staying up at night worrying about the stability of our primary care workforce."
"This debate over health center funding comes as clinicians are considering what residency they should go on, what training program, or whether or not they should sign a contract at a community health center," he added. "That is why it makes sense to invest in health centers and in primary care development programs to grow the current workforce of 285,000 health center professionals."
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'Now Is the Time to Act': Sanders Pushes Bipartisan Bill to Solve Primary Care Crisis
"Providing Americans with a medical home will not only save lives and ease suffering," said the senator. "It will save billions of dollars. Providing primary care to all is not only smart healthcare, it is cost-effective healthcare."
Aug 16, 2023
In an op-ed on Wednesday, U.S. Sen. Bernie Sanders made the case for the bipartisan legislation he introduced last month to address the nation's shortage of doctors and nurses as well as the "primary care cliff" that he has warned millions of Americans are heading toward if Congress does not act to fund the community health centers that many Americans rely on.
Writing at The Daily Beast, the Vermont independent senator said the country's for-profit healthcare industry—in addition to leaving more than 27 million Americans without health insurance—has failed to recruit and retain a sufficient number of medical providers, with the American Association of Medical Colleges projecting a shortage of 122,000 doctors by 2032.
A shortage of 400,000 home health aides—badly needed in a country where the population of people over age 65 is expected to grow by nearly 50% in the next decade—is also expected, and as Sanders wrote, "over the next two years alone it is estimated that we will need between 200,000 and 450,000 more nurses."
The healthcare provider shortage can partially be blamed, said Sanders, on disinvestment in primary care and a heavy focus on "hospital and tertiary care," with the for-profit system forcing many uninsured people "with common illnesses into emergency rooms—the most expensive form of primary care."
"Most countries spend between 10% to 15% of their healthcare budgets on primary healthcare," wrote Sanders, who chairs the Senate Health, Education, Labor, and Pensions (HELP) Committee and has for decades pushed for a government-funded universal healthcare system. "Canada spends 13%, Germany spends 15%, Spain spends 17%, and Australia spends 18%. We spend less than 7%."
While spending less on preventive care than other wealthy countries, the U.S. spends three to four times more on its healthcare system overall than countries including New Zealand, South Korea, and Japan, and more than twice as much as the U.K., France, and Australia.
But with a system that "can seem designed to discourage people from using services," noted the Commonwealth Fund in a report earlier this year, the U.S. has a higher rate than other wealthy countries of adults with chronic health conditions, and "Americans see physicians less often than people in most other countries."
"Every major medical organization in the country agrees that what we are investing in primary healthcare is woefully inadequate," the senator wrote on Wednesday. "They understand that focusing on disease prevention and providing Americans with a medical home will not only save lives and ease suffering. It will save billions of dollars. Providing primary care to all is not only smart healthcare, it is cost-effective healthcare."
Sanders' bill, the Primary Care and Health Workforce Expansion Act, would expand the Graduate Medical Education and Teaching Health Center Graduate Medical Education programs as well as the National Health Service Corps—steps that would "significantly increase the number of doctors in our country" and ensure more doctors are licensed to provide primary rather than specialty care.
The bill would also provide incentives to encourage medical schools to graduate more primary care providers and expand programs that address the shortage of instructors in nursing programs—which has impacted the number of people who are able to go into the nursing field.
With community health centers currently facing a potential 70% funding cut if Congress does not act to expand federal investments, the legislation also provides funding to provide the facilities with $65.5 billion over five years. The funding would be used for expanded operating hours, the creation of school-based health centers, mental healthcare, substance use disorder care, and dental care.
"This bill would increase the number of these centers throughout the country, concentrating on rural and urban areas which are now medically underserved," wrote Sanders. "The result: millions more Americans would be able to receive the primary healthcare they need in a timely and cost-effective way."
Sanders noted that "the day must come, sooner than later, when we join the rest of the industrialized world and guarantee healthcare for every man, woman, and child as a human right through a Medicare for All single-payer system. That is the right thing to do, that is the humane thing, and that is the cost-effective thing to do."
Until then, he wrote, lawmakers must take action to significantly improve a healthcare system in which "tens of millions of Americans, even those with decent insurance, cannot find the medical care they need on a timely basis" due to provider shortages.
"For many years members of Congress have talked about our healthcare crises," said the senator. "Now is the time to act."
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Congress Takes Recess as Childcare and Health Center Funding Cliffs Loom
"Healthcare for so many people, most of whom have limited resources and are struggling with chronic health conditions, is critical and cannot lapse."
Aug 01, 2023
More than 3 million kids across the United States could lose childcare and nearly 7 million patients could lose access to primary care if Congress doesn't approve funding by September 30.
But lawmakers in both the House and Senate left town for August recess late last week after making little noticeable progress toward averting the looming care funding cliffs and keeping the federal government open.
Unless Congress acts by the end of September, the government will shut down—a potential outcome that Republicans are using as leverage to pursue painful spending cuts to education, childcare programs, environmental protection, and more.
The Senate is set to return from recess on September 5 and House lawmakers will be back in Washington, D.C. on September 12, leaving them with little time to prevent disaster.
The Century Foundation warned in a recent report that roughly 3.2 million children could lose their childcare spots—and more than 230,000 childcare workers could lose their jobs—if Congress allows emergency funding provided under the American Rescue Plan to expire without any additional investments.
In a memo released last month, the National Women's Law Center and other advocacy organizations called for an investment of at least $16 billion per year to "stave off shrinking childcare spots, staffing shortages, and rising prices that will disrupt both families and our economy writ large."
"Allowing the [American Rescue Plan] supplemental funding to expire without providing new childcare funding would mean fewer families eligible for childcare assistance, more eligible families on the waiting list for assistance, more burdensome copayments for families receiving assistance, and stagnant or reduced payments to childcare programs," the groups said.
The potential lapse of childcare funding has sent states scrambling to prepare.
Last week, Democratic Wisconsin Gov. Tony Evers delivered an address warning that if the state Legislature doesn't act quickly, "2,110 childcare programs could close their doors, we could lose over 4,800 childcare jobs, and over 87,000 children could be left without care" once American Rescue Plan funding runs out.
"That would be a catastrophe for our state's economy, workforce, and businesses, potentially causing about half a billion dollars in economic impacts across our state," Evers said.
Advocates and progressive lawmakers are also sounding the alarm over the possible expiration of community health center funding at the end of next month.
While the House Energy and Commerce Committee has passed legislation that would boost health center funding by $4.2 billion annually for the next two years, the Senate has yet to reach an agreement.
Sen. Bernie Sanders (I-Vt.), the chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, wants to go further. Last month, Sanders introduced legislation that would invest $20 billion over a five-year period into expanding community health centers—which provide care to around 30 million people nationwide—and boost funding for doctors, nurses, and other healthcare workers.
As The Washington Postreported Tuesday, Sen. Bill Cassidy (R-La.)—the top Republican on the Senate HELP Committee—"slammed [Sanders'] proposal as 'partisan legislation that cannot pass the Senate.'"
"Sanders wound up canceling a planned markup of his bill," the Post added. "Instead, he pledged to work with lawmakers on the committee—such as Sen. Roger Marshall (R-Kan.)—to have legislation ready by the first week of September."
The National Association of Community Health Centers (NACHC) recently estimated that "almost 7 million patients will lose access to care if Congress does not extend health center funding."
"Healthcare for so many people, most of whom have limited resources and are struggling with chronic health conditions, is critical and cannot lapse," Rachel Gonzales-Hanson, NACHC's interim president and CEO, said in a statement last month.
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