Marshall and Sanders Announce Bipartisan Legislation on Primary Care

Washington, D.C. – U.S. Senator Roger Marshall, M.D., Ranking Member of the Subcommittee on Primary Health and Retirement Security, and Sen. Bernie Sanders (I-VT), chairman of the Senate, Health, Education, Labor, and Pensions Committee, have reached a deal to address the primary care crisis in America and the major shortages of nurses, primary care doctors and other important health care jobs across the country, and to increase critical funding for community health centers, the National Health Service Corps and Teaching Health Centers. 

“I’ve always said that I’d work with any of my colleagues as long as the person sitting across the table and I have the same common goal. Senator Sanders and I share our belief that every American should have access to affordable, meaningful healthcare,” Senator Marshall said. “Community health care centers are a vital player in addressing the health care challenges we face today. This legislation expands American’s access to these health centers that provide excellent care like in-house mental health services, dental care, and nutrition coaching. Our bill also recognizes and addresses the challenges our health care industry is facing, like the shortage of nurses and primary care doctors, and includes programs to bolster the workforce in a fiscally responsible way. We believe this investment will save Medicaid and Medicare tens of billions of dollars and, more importantly, provide improved health care outcomes for all Americans.”

“After over a month of very productive and thoughtful negotiations, I am delighted to announce that Senator Marshall and I have reached an agreement on a historic bipartisan bill to expand primary care and to reduce the massive shortage of nurses and primary care doctors in America,” Senator Sanders said. “It is unacceptable that millions of Americans throughout our country do not have access to affordable, high-quality primary care and are unable to get the health care they need when they need it. Every major medical organization understands that our investment in primary care is woefully inadequate. They understand that focusing on disease prevention and providing more Americans with a medical home instead of relying on expensive emergency rooms for primary care will not only save lives and human suffering, it will save money. This bipartisan legislation is not only good public policy, it is cost-effective. I look forward to working with all of my colleagues in the HELP Committee to advance this legislation through the Senate and get it signed into law as soon as possible.”

According to the most recent estimates, over the next decade, the United States faces a shortage of over 120,000 doctors — including a huge shortage of primary care doctors. The nursing shortage may be even worse. Over the next two years alone, it is estimated that we will need between 200,000 and 450,000 more nurses.

The Marshall-Sanders agreement answers this crisis by providing over $26 billion in funding to expand primary care in America and address the health care workforce shortage:

• Provides $5.8 billion a year over the next three years in mandatory funding for community health centers, which provide high-quality primary health care to more than 30 million Americans.
• Within those funds, there is a $245 million per year set aside to expand hours of operation at community health centers and $55 million per year for school-based health services.
• Health centers will be newly required to provide nutrition services.
• This legislation also provides $3 billion in capital funding primarily to enable community health centers to expand dental care and mental health care in their facilities.
• Increases funding for the National Health Service Corps from $310 million to $950 million per year over the next three years to provide 2,100 scholarships and debt forgiveness for some 20,000 doctors, nurses, dentists, mental health providers, and other health care professionals who commit to working in our nation’s most underserved areas.
• Provides $1.5 billion over the next five years in the Teaching Health Center Graduate Medical Education program to create more than 700 new primary care residency slots, which would result in up to 2,800 additional doctors by 2031. This program increases the number of primary care physicians and dental residents trained in community-based settings. In Academic Year 2021-2022, the program funded more than 930 individual primary care medical and dental residents, who provided more than 1.1 million hours of patient care to more than 800,000 patients in medically underserved and rural areas. 
• Addresses the nursing shortage in America by investing $1.2 billion in grants to community colleges and state universities to increase the number of students enrolled in accredited, two-year registered nursing programs. The schools receiving these awards must use them to expand their class sizes and grow the number of 2-year nurses trained across the country. This provision would allow schools to train up to 60,000 additional 2-year nurses.
• Provides $300 million to produce an additional 2,000 primary care doctors by 2032. The bill will also increase residency programs in rural America through an investment in the Rural Residency Planning and Development program and investment in training and workforce programs for dentists and dental assistants.

The legislation will be fully paid for 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, among other provisions.

The legislation will be marked up in the HELP Committee on Thursday, Sept. 21. 

To read the summary of the legislation, click here. 

To read the legislation, click here.