By Stephanie Krenrich, Senior Vice President of Policy & Government Affairs, Advocates for Community Health
As Congress considers its year-end agenda, Advocates for Community Health (ACH) is urging lawmakers to advance policies that strengthen community health centers and protect the care that nearly 34 million patients depend on.
In our October 15 letter to congressional leadership, we outlined priorities spanning 340B, federal funding, Medicare payment, workforce development, and Medicaid. Together, these policies would help health centers sustain comprehensive primary care while responding to growing financial and operational pressures.
ACH’s 55 member health centers serve more than four million patients across 22 states, and the District of Columbia and Puerto Rico. Their experience informs our message to Congress: health centers are a proven, bipartisan solution to improving access and addressing health care costs, and federal policy must support their ability to deliver.
Delaying the 340B Rebate Model
At the forefront of our priorities is passage of the 340B Rebate Model Delay Act, H.R. 10770, before the end of the year. The bipartisan legislation, sponsored by Representatives Rob Bresnahan (R-PA), Debbie Dingell (D-MI), Tracey Mann (R-KS), and Lois Frankel (D-FL), would delay implementation of the 340B Rebate Model Pilot Program for two years and preserve upfront discounts.
Health centers rely on timely 340B savings to support patient services, staffing, equipment, and pharmacy operations. Requiring them to purchase affected medications at full price and wait for rebates would tie up limited resources, create cash-flow risks, and impose new administrative and technology costs.
Those pressures could undermine services supported by 340B savings, including behavioral health, chronic disease management, transportation, and care in rural communities. Health centers would also face these changes while preparing for significant new Medicaid requirements stemming from H.R. 1, compounding the operational burden.
A two-year delay would give Congress time to consider comprehensive, bipartisan 340B reform and clearly establish its intent for the program. It would also give covered entities additional time to prepare for potential changes.
Protecting 340B for the Long Term
Beyond delaying the rebate model, our letter calls on Congress to enact comprehensive reform that protects 340B’s purpose and strengthens its long-term sustainability.
Every respondent to an ACH member survey reported reinvesting 340B savings in patient care and community services. These investments include telehealth, mobile and school-based care, behavioral health, transportation, and chronic disease management.
ACH supports clear, consistent, practical standards that promote transparency and accountability while preserving those investments.
The bipartisan SUSTAIN 340B Act, S. 5244, includes several provisions ACH supports: recognition of contract pharmacies’ essential role in patient access, clearer participation and oversight expectations, practical transparency measures, and preservation of upfront discounts.
ACH also supports provisions in the SECURE 340B Act, H.R. 9599, addressing the rebate model, defining patient eligibility, establishing contract pharmacy and data-sharing rules, and strengthening federal oversight. The legislation would also establish an independent, conflict-free clearinghouse to prevent duplicate discounts and protect patient information.
Our goal is to ensure that reforms preserve access and strengthen health centers’ ability to serve their communities.
Securing Long-Term Health Center Funding
Our letter also urges Congress to build on its recent bipartisan investment in the Community Health Center Fund, which expires at the end of this year.
ACH is requesting $7.87 billion annually for at least three years for the fund and $2.88 billion in discretionary funding for the Health Center Program in fiscal year 2027.
Long-term funding would give health centers greater certainty to retain their workforce, maintain essential services, and expand access. It would also allow them to plan for community needs instead of operating from one short-term extension to the next.
Modernizing Medicare Payment
Health center payment rates have not kept pace with the costs of delivering comprehensive care. As more Medicare beneficiaries seek care at health centers, addressing that gap is increasingly important.
ACH is urging Congress to enact the bipartisan Community Health Center Reforms Enabling Better Access for Seniors and Elders (CHC REBASE) Act, H.R. 10398, led by Representatives Mike Rulli (R-OH) and Debbie Dingell (D-MI).
The legislation would allow CMS to rebase Medicare’s Prospective Payment System to better reflect care costs, update qualifying services, establish payment parity for health center medical visits delivered through telehealth, and streamline Medicare Advantage wraparound payments.
Investing in the Workforce
Health centers need federal support to recruit and retain primary care, behavioral health, dental, and other professionals.
Our letter calls for passage of the Developing the Community Health Workforce Act, H.R. 8629, which would strengthen loan repayment, workforce pipelines, health center-hospital training partnerships, and the behavioral health workforce.
We also urge Congress to increase National Health Service Corps funding to $950 million annually and support funding for the Teaching Health Center Graduate Medical Education program, which trains clinicians in community-based settings.
Preserving Medicaid Coverage and Access
Nearly half of Health Center Program patients are covered by Medicaid or the Children’s Health Insurance Program. Stable coverage supports patients’ access to preventive services, primary care, behavioral health, and chronic disease management.
As states implement new Medicaid community engagement requirements, ACH is urging Congress to recognize the consequences of coverage disruptions and additional administrative demands. These changes risk delaying care, increasing uncompensated care, and placing greater pressure on health center finances and staff.
Our request is to protect stable Medicaid funding, adequate reimbursement, and policies that preserve coverage and access.
As Congress moves toward the end of the year, ACH will continue advocating for this full agenda, with particular urgency around protecting upfront 340B discounts and passing the Rebate Model Delay Act. Each priority supports the same outcome: ensuring health centers can continue providing comprehensive, affordable care in the communities that need them.