On September 14, 2023, Senators Roger Marshall, M.D., and Bernie Sanders announced bipartisan legislation Bipartisan Primary Care and Health Workforce Act on improving primary care in the United States. Through the bipartisan proposal, the Senators are hoping to help resolve the shortages of nurses, primary care doctors, and other health care jobs throughout the country. They also aim to increase “critical funding for community health centers, the National Health Service Corps and Teaching Health Centers.”
According to estimates, the United States faces a shortage of more than 120,000 doctors (including a large shortage of primary care doctors) and a shortage of even more nurses. Over the next two years, it’s estimated that the United States will need between 200,000 and 450,000 more nurses.
The agreement provides more than $26 billion in funding to expand primary care in America and address the coming health care workforce shortage. Included in that funding is $5.8 billion per year for the next three years in mandatory funding for community health centers, which provide high-quality primary care to more than 30 million Americans around the country. There is another $245 million per year set aside to expand the hours of operation at those community health centers, as well as $55 million per year for school-based health services, and $3 billion in capital funding primarily aimed at helping community health centers to expand their dental and mental health care in their facilities.
The National Health Service Corps will also see an increase in funding, from $310 million to $950 million per year over the next three years, to provide 2,100 scholarships and debt forgiveness for about 20,000 doctors, nurses, dentists, mental health providers, and other health care professionals who commit to working in underserved areas on an annual basis.
The Teaching Health Center Graduate Medical Education program will be reauthorized under the legislation, resulting in a total of $1.5 billion under the agreement. This will allow the program to create more than 700 new primary care residency slots, which may result in as many as 2,800 additional doctors by 2031.
The legislation also includes $300 million in investment in the Rural Residency Planning and Development program and in training and workforce programs for dentists and dental assistants.
As far as the nursing shortage, the legislation would allow for $1.2 billion to be invested in grants given to community colleges and state universities to increase the number of students enrolled in accredited, two-year registered nursing programs. Any school that receives such a grant will be required to use it to expand their class sizes and grow the number of 2-year nurses trained across the country, allowing for as many as 60,000 additional 2-year nurses. The legislation also provides $28.5 million in annual discretionary appropriations in 2024 – 2026, and an additional $28.5 million per year for three years through a one-time mandatory supplemental. This funding would support roughly 1,000 new nurse faculty entering the workforce each year, for a total of 3,000 new graduates with the intent to teach.
Additionally, the legislation asks the Government Accountability Office to study and report on the effectiveness of the National Health Service Corps at attracting health care professionals to Health Professional Shortage Areas (HPSA) and requires an evaluation of HPSA calculation.
According to the Senators, the legislation would be paid for in its entirety by “combatting the enormous waste, fraud, and abuse in the health care system, making it easier for patients to access low-cost generic drugs, and holding pharmacy benefit managers accountable.”
The Senate Committee on Health, Education, Labor, and Pensions (HELP) will mark the legislation up on Thursday, September 21, 2023.