President Biden yesterday released a revised framework for a $1.75 trillion social spending bill, which includes numerous health care provisions. Democrats are attempting to pass the bill under reconciliation, and the House Committee on Rules yesterday began consideration of a modified version of the Build Back Better Act (H.R.5376). The 1,684-page bill, which will likely go through additional changes, could be voted on in the House as early as next week along with the bipartisan infrastructure legislation passed by the Senate in August. 
 
Among other health care provisions, the revised version of the Build Back Better Act would: 

  • Expand health care coverage by permanently funding the Children’s Health Insurance Program and expanding eligibility for coverage through the Health Insurance Marketplaces for those under 138% federal poverty level, including for individuals not previously eligible for Medicaid because their state failed to expand. States that fail to expand their Medicaid program face reductions in Medicaid Disproportionate Share Hospital payments and federal funding for uncompensated care pools. The legislation also would encourage all states to maintain eligibility levels in place prior to the COVID-19 public health emergency and would increase the federal match for expansion populations in every state for 2023-2025 from 90% to 93%. 
  • Add hearing benefits to the traditional Medicare program.
  • Fund medical school scholarships and residencies, and increase funding for graduate medical education at teaching health centers and children’s and veterans hospitals.  
  • Take steps to improve maternal health by expanding access to behavioral health services and addressing drivers of mortality, inequities and disparities, as well as impose civil monetary penalties for violating parity laws.
  • Extend certain workforce programs and fund programs to address community violence, including Hospital Violence Intervention Programs. 
  • Take steps to improve the public health infrastructure, including by helping to shore up the supply chain and provide additional funding to federal agencies for emergency response.
  • Increase certain civil monetary penalties for various violations of the Occupational Safety and Health Act and National Labor Relations Act.

The legislation does not include hospital infrastructure funding under the Hill-Burton program that was in the earlier version of the bill.    
  
The AHA will provide additional details, including any changes to the health care provisions, as the legislation progresses through the House.
 

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