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President Biden’s “Build Back Better” plan would invest in medical colleges and programs to address the shortage of doctors. Biden is imploring Congress to move the package, but it's still a long way from the president's desk.
Lawmakers in Washington are still working on a $1.75 trillion spending package that offers plenty for healthcare, if Congress can get it to the finish line.
Fresh off securing a $1.2 trillion infrastructure package, President Biden is pushing lawmakers to approve his “Build Back Better” plan to help revive the economy and boost social service programs. For hospitals and healthcare systems, there’s a great deal at stake.
The measure would include substantial investments for academic medical centers. It also includes provisions to address the shortage of physicians.
A major component of the package is health equity. Karen Fisher, chief public policy officer for the Association of American Medical Colleges, said the Biden administration is viewing policies on healthcare with an eye on addressing inequities in care among vulnerable groups.
“This administration has made health equity a key priority,” Fisher said.
The key is getting sufficient Congressional support to get the bill to Biden’s desk. While Democrats hold narrow control of both the House and Senate, there has been plenty of debate among Democrats about the size and scope of the spending package.
Despite the cost and complexity of the legislation, Fisher said she thinks lawmakers will ultimately approve the package.
Democrats have plenty of motivation after some stinging losses on Election Day, she said. Democratic lawmakers will want to show they can deliver for Americans. And the congressional mid-term elections are less than a year away.
“They’re going to figure out a way to get this done,” Fisher said. But she added, “It’s not going to be pretty.”
At the AAMC’s annual conference this week, Fisher outlined the status of the legislation and what’s at stake for healthcare.
House lawmakers have proposed 4,000 Medicare-financed slots for graduate medical education. The legislation would call for 25% of those slots to go to primary care specialties and 15% for psychiatry and other behavioral health programs. Some of those slots would be earmarked to teaching hospitals in rural areas and those with a shortage of healthcare professionals.
The spending package includes a provision for an additional 1,000 Medicare-supported GME slots for the Pathways to Practice Training Program, another initiative aimed at tackling the shortage of doctors. The program would cover the tuition and fees for those students, and recipients would need to commit to work in an underserved area for each year they receive scholarships.
Those programs could expand the number of doctors and bring in more aspiring doctors from diverse backgrounds, Fisher said.
She urged healthcare leaders to press lawmakers about the importance of those measures.
Lower drug prices
A recent provision added to the spending package would allow Medicare to negotiate with pharmaceutical companies on prices for “a small number of drugs," Fisher said.
“It’s a starting point,” Fisher said.
Medicare would be able to negotiate prices on a select number of Medicare Parts B & D prescription drugs, beginning in 2025.
Another key provision: seniors’ out-of-pocket prescription drug prices would be capped at $2,000, beginning in 2024.
The Biden administration projects it could save $250 billion in its various drug-related policies. If approved, the savings on drug prices would help finance other healthcare provisions in the package, she said.
The spending package again includes, for now, $500 million in grants to improve the infrastructure of medical schools. This provision was recently removed from the legislation but has been added again, the AAMC notes.
The grants could be used to improve infrastructure, build new campuses and expand efforts to recruit diverse faculty and students.
The package would provide $2 billion for the National Health Service Corps, which places health care professionals in areas with limited access to medical care. The program offers scholarships to those who commit to primary health care services; recipients must commit to two years or service.
The package also includes funding to address maternal mortality. Federal statistics show Black women are more likely to die in childbirth than other racial groups.
The measure would give children’s hospitals $200 million for graduate medical education.
The legislation would create 500 residency positions for Veterans Affairs Medical Centers.