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Kids’ Access to Primary Care Act of 2025

USA119th CongressHR-1433| House 
| Updated: 2/18/2025
Kim Schrier

Kim Schrier

Democratic Representative

Washington

Cosponsors (10)
Terri A. Sewell (Democratic)Steve Cohen (Democratic)Suzan K. DelBene (Democratic)Paul Tonko (Democratic)Donald G. Davis (Democratic)Marilyn Strickland (Democratic)Kathy Castor (Democratic)Seth Magaziner (Democratic)Brian K. Fitzpatrick (Republican)Grace Meng (Democratic)

Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
This bill aims to enhance access to primary care services for Medicaid beneficiaries by renewing a provision that requires states to pay primary care providers at rates comparable to Medicare. Specifically, it mandates that Medicaid reimbursement for primary care services be no less than 100 percent of the Medicare Part B payment rate, or the 2009 Medicare rate if higher. This reestablishes a payment floor that was previously in effect for a limited period. The legislation significantly expands the types of providers eligible for these enhanced rates. Beyond family medicine, general internal medicine, and pediatric physicians, it now includes board-certified obstetrics and gynecology physicians and subspecialists in these fields. Additionally, advanced practice clinicians, rural health clinics, Federally-qualified health centers, nurse practitioners, physician assistants, and certified nurse-midwives are also covered, provided they meet specific supervision or state law requirements. To ensure proper implementation, the bill requires Medicaid managed care entities to comply with these payment rate requirements and provide documentation to states. It also excludes emergency department services from qualifying for the enhanced primary care rates, aiming to improve targeting. Finally, the Secretary of Health and Human Services is directed to conduct a study on the policy's impact, comparing child enrollment, provider participation, and payment rates before and after its enactment.
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Timeline

Bill from Previous Congress

HR 117-1025
Kids’ Access to Primary Care Act of 2021

Bill from Previous Congress

HR 118-952
Kids’ Access to Primary Care Act of 2023

Bill from Previous Congress

HR 116-6159
Kids’ Access to Primary Care Act of 2020
Feb 18, 2025
Introduced in House
Feb 18, 2025
Referred to the House Committee on Energy and Commerce.
Feb 26, 2025

Latest Companion Bill Action

S 119-760
Introduced in Senate
  • Bill from Previous Congress

    HR 117-1025
    Kids’ Access to Primary Care Act of 2021


  • Bill from Previous Congress

    HR 118-952
    Kids’ Access to Primary Care Act of 2023


  • Bill from Previous Congress

    HR 116-6159
    Kids’ Access to Primary Care Act of 2020


  • February 18, 2025
    Introduced in House


  • February 18, 2025
    Referred to the House Committee on Energy and Commerce.


  • February 26, 2025

    Latest Companion Bill Action

    S 119-760
    Introduced in Senate

Health

Related Bills

  • S 119-760: Kids’ Access to Primary Care Act of 2025
Child healthGovernment studies and investigationsHealth personnelHealth promotion and preventive careMedicaidMedical tests and diagnostic methodsMedicareNursingWomen's health

Kids’ Access to Primary Care Act of 2025

USA119th CongressHR-1433| House 
| Updated: 2/18/2025
This bill aims to enhance access to primary care services for Medicaid beneficiaries by renewing a provision that requires states to pay primary care providers at rates comparable to Medicare. Specifically, it mandates that Medicaid reimbursement for primary care services be no less than 100 percent of the Medicare Part B payment rate, or the 2009 Medicare rate if higher. This reestablishes a payment floor that was previously in effect for a limited period. The legislation significantly expands the types of providers eligible for these enhanced rates. Beyond family medicine, general internal medicine, and pediatric physicians, it now includes board-certified obstetrics and gynecology physicians and subspecialists in these fields. Additionally, advanced practice clinicians, rural health clinics, Federally-qualified health centers, nurse practitioners, physician assistants, and certified nurse-midwives are also covered, provided they meet specific supervision or state law requirements. To ensure proper implementation, the bill requires Medicaid managed care entities to comply with these payment rate requirements and provide documentation to states. It also excludes emergency department services from qualifying for the enhanced primary care rates, aiming to improve targeting. Finally, the Secretary of Health and Human Services is directed to conduct a study on the policy's impact, comparing child enrollment, provider participation, and payment rates before and after its enactment.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline

Bill from Previous Congress

HR 117-1025
Kids’ Access to Primary Care Act of 2021

Bill from Previous Congress

HR 118-952
Kids’ Access to Primary Care Act of 2023

Bill from Previous Congress

HR 116-6159
Kids’ Access to Primary Care Act of 2020
Feb 18, 2025
Introduced in House
Feb 18, 2025
Referred to the House Committee on Energy and Commerce.
Feb 26, 2025

Latest Companion Bill Action

S 119-760
Introduced in Senate
  • Bill from Previous Congress

    HR 117-1025
    Kids’ Access to Primary Care Act of 2021


  • Bill from Previous Congress

    HR 118-952
    Kids’ Access to Primary Care Act of 2023


  • Bill from Previous Congress

    HR 116-6159
    Kids’ Access to Primary Care Act of 2020


  • February 18, 2025
    Introduced in House


  • February 18, 2025
    Referred to the House Committee on Energy and Commerce.


  • February 26, 2025

    Latest Companion Bill Action

    S 119-760
    Introduced in Senate
Kim Schrier

Kim Schrier

Democratic Representative

Washington

Cosponsors (10)
Terri A. Sewell (Democratic)Steve Cohen (Democratic)Suzan K. DelBene (Democratic)Paul Tonko (Democratic)Donald G. Davis (Democratic)Marilyn Strickland (Democratic)Kathy Castor (Democratic)Seth Magaziner (Democratic)Brian K. Fitzpatrick (Republican)Grace Meng (Democratic)

Energy and Commerce Committee

Health

Related Bills

  • S 119-760: Kids’ Access to Primary Care Act of 2025
  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
Child healthGovernment studies and investigationsHealth personnelHealth promotion and preventive careMedicaidMedical tests and diagnostic methodsMedicareNursingWomen's health