Last week, the Association of Clinicians for the Underserved (ACU) applauded the introduction of S. 2840, the Bipartisan Primary Care and Health Workforce Act, a bipartisan bill being led by Senators Sanders (I-VT) and Marshall (R-KS), which aims to address the primary care crisis and major shortages of nurses, primary care physicians, and other healthcare professionals across the U.S. and to increase critical funding for community health centers, the National Health Service Corps (NHSC), and Teaching Health Centers.

ACU is proud to have led a coalition of partners and stakeholders in advocating for this legislation and its proposed $950 million in increased funding for the NHSC. Additionally, we are grateful not only to Senators Sanders (I-VT) and Marshall (R-KS), but also to Senators Durbin (D-IL) and Rubio (R-FL) for having driven support for this increase and having stepped forward to demonstrate strong bi-partisan support for continued investment in the Corps.

We are excited to report that yesterday, September 22, during a Senate Committee on Health, Education, Labor and Pensions (HELP Committee) bill markup hearing, the Bipartisan Primary Care and Health Workforce Act was approved by a vote of 14-7. Senators Roger Marshall (R-KS), Mike Braun (R-IN), and Lisa Murkowski (R-AK) joined all Democrats in support of the bill. Opposition to this legislation consisted of the remaining seven Republicans on the HELP Committee: Senators Bill Cassidy, MD (LA), Rand Paul (KY), Susan Collins (ME), Mitt Romney (UT), Tommy Tuberville (AL), Markwayne Mullin (OK), and Ted Budd (NC).

Major Funding Provision Increases and Changes

National Health Service Corps (NHSC)
  • Increases annual mandatory funding from around $330 million to $950 million per year for three years (FY2024 to FY2026).
Community Health Centers (CHCs)
  • Increases annual mandatory funding from $4 billion to $5.8 billion for three years (FY24-26).
  • Provides $3 billion over three years for one-time capital investments, with priority on activities to expand behavioral health and dental services.
  • Makes behavioral health (BH) services (including both mental health and substance use disorder services) required services for all CHCs.
    • *Chairman Sanders mentioned there was an agreement that $500 million of the new funding should be directed towards helping CHCs come into compliance with the new requirement.
Teaching Health Center Graduate Medical Education (THCGME) Program
  • Increases annual funding from $127 million to $300 million for the next 5 years.
  • Increases the THC-GME per-resident amount by $10,000 per year each year from 2024-2028.

Senators Sanders, Marshall, and Braun all spoke about how S. 2840 offers a solution to our country’s urgent need to address major workforce shortages.

“This legislation triples funding for the National Health Service Corps from $310 million to $950 million for the next three years. As everyone here knows, the National Health Service Corps provides student debt forgiveness and scholarships to doctors, dentists, and other medical professionals who practice in underserved areas. We need to get health professionals into rural areas. I have heard this time and time and time again in underserved areas. And that is what expanding the National Health Service Corps can do,” said Chairman Sanders.

“No one can deny that this bill addresses the issue of nursing shortages. It actually turns it around in three years’ time. Can you imagine being in Congress, and you can actually solve a problem in three years? [The Bipartisan Primary Care and Health Workforce Act] helps address the primary care doctor issue as well as the dental, mental and behavioral health providers,” said Senator Marshall, MD. In response to those who had concerns about offsets, Senator Marshall added that he is “fully committed to making sure that this bill is paid for in a responsible manner. And in saying that, … this [bill] is going to save American taxpayers millions if not billions of dollars. There are lots of arguments to be made on each side of this, but at the end of the day, this is doing the right thing. I think this is a very viable solution [that] will give meaningful affordable healthcare access [to] millions of Americans.”

Corporate hospitals and insurance providers across the country are “generally the ones that weigh in and complain about anything you do to try and change the status quo. I’m glad that we are at least here today taking one small piece of it. When you’ve got practitioners that I talk to all across Indiana regretting that they’ve gone to medical school and the ones that have gotten out wrestling with sooner or later maybe selling their clinics to private equity [groups] or a corporate hospital chain, something has got to give,” said Senator Braun (R-IN). He went on to thank Chairman Sanders and Senator Marshall for all they have done with bringing this workforce issue to the forefront and drafting S. 2840.

Read reactions about the HELP hearing from other Senators: Dick Durbin (D-IL) or Maggie Hassan (D-NH).

What Happens Now?

The outcome of yesterday’s Committee hearing was a major win for ACU’s advocacy coalition, but much work still remains to be done. Here’s where things stand in the legislative process and what needs to happen next to make this legislation a reality:

Legislative Process in the Senate

1. Introduction of Legislation

Senators Sanders and Marshall introduced S. 2840, the Bipartisan Primary Care and Health Workforce Act, which was referred to the HELP committee (the chamber with jurisdiction over its elements).

2. Committee Consideration: Congress just completed this step!

The HELP committee holds a hearing to markup on the bill, at which committee members vote on any proposed amendments. The markup concludes when the committee agrees, by majority vote, to report the bill (with any recommended changes adopted in the markup) to its chamber.

3. Floor Scheduling

In the Senate, bills are brought to the floor only after the Senate agrees to a motion to proceed to a specific bill or, alternatively, if no Senator objects to a unanimous consent request to bring it up.

4. Senate Floor Consideration

In the Senate, once the chamber has agreed to bring up a bill, the debate and amendment process for it may begin.

5. Resolving Differences between the Chambers

At some point in the legislative process, the Senate and House must agree on a bill that can be presented to the President.

6. Presidential Action

The President has 10 days, excluding Sundays, to sign or veto a bill.

Remember: Without Legislation, The Clock Is Ticking Until the NHSC Loses ALL Guaranteed Funding

NHSC Funding Ends In

Now is the vital time to urge Congress to enact this legislation and make renewed and expanded funding for the National Health Service Corps (NHSC) a reality. Become an advocate with ACU today and ask your colleagues to join us as well!

Jordan Marshall, Your ACU Advocacy Contact

Jordan Marshall, Deputy Director of Policy & AdvocacyJordan Marshall is leading ACU’s grassroots advocacy to secure long-term funding for the National Health Service Corps (NHSC). Contact Jordan with any questions regarding policy analysis or if ACU can be of assistance with your own organizational or individual advocacy.