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Health Reform Implementation
 

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Health Workforce Overview 

States are moving forward with implementing provisions of the Patient Protection and Affordable Care Act (PPACA) which expand insurance coverage and delivery systems. Health care providers must be able to handle the increased need for services.  The PPACA will support existing state efforts to address health care provider shortages across several professions; increase workforce capacity in rural areas through the National Health Service Corps; and address licensure and regulatory issues related to providers.  Through the Prevention and Public Health Fund, PPACA will increase the number of primary care physicians, physician assistants’ expertise in primary care, and the number of nurse practitioners (while also establishing new nurse practitioner-led clinics). The law will also provide states with $2.75 billion in 2013 and 2014 and $2 billion annually after that starting in 2015 to increase their health care workforce from 10 percent to 25 percent over the next 10 years. The PPACA also aims to invest in graduate medical education, increasing resources for training, and providing incentives for providers who serve in underserved areas. Since 2011 there have been 73 bills proposed in 19 different states, territories or DC, one of which was vetoed and 14 of which have been signed into law

The American Recovery and Reinvestment Act, which preceded health reform, provided approximately $500 million in funding for training programs for health professions, such as physicians, dentists, nurses and others. The majority of this funding was allocated for expanding the National Health Service Corps, the federal program that recruits family or primary care physicians to practice in under-served areas in exchange for financial assistance with their loans.

The Patient Protection and Affordable Care Act (PPACA) contains provisions to strengthen the health workforce, especially the primary care workforce, including but not limited to:

  • Increasing funding for community health centers. Effective 2010.
  • Expanding and improving low-interest student loan programs, scholarships, and loan repayments for health students. Effective 2010.
  • Establishing an independent National Health Care Workforce Commission to provide comprehensive, nonbiased information and recommendations to Congress and the administration for aligning federal health care workforce resources with national needs. Effective no later than Sept. 30, 2010.
  • Providing tax relief for health professionals with state loan repayment. Effective for amounts received by an individual in taxable years beginning after Dec. 31, 2008.
  • Increasing reimbursement for primary care services for Medicare (effective 2011) and Medicaid (effective 2013).
  • Establishing a Graduate Medical Education policy allowing unused training slots to be re-distributed for purposes of increasing primary care training at other sites and adjusting the Medicare Medical Education program to expand the size of the primary care and nursing workforce. Effective July 1, 2011.

    For a more complete list and summary of the workforce provisions in the PPACA:

 Summary of the Health Workforce Provisions in The Patient Protection and Affordable Care Act: H.R. 3590  (2010)

For more information, contact: Laura Tobler (Health Program, Denver)  |  Rachel Morgan (federal-State,  Wasington, D.C.) | Kara Nett Hinkley (Health Program, Denver, Colo.)

 
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NCSL Health Programs

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NCSL's 2013 Legislative Summit

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