Congress quietly extends healthcare payment floor for primary care doctors
H.R. 1433 — Kids’ Access to Primary Care Act of 2025 · Filed by Kim Schrier (D-WA) · 11 cosponsors · Introduced Feb 18, 2025 · Referred to committee
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What it does
This bill renews and expands a Medicaid payment floor that requires states to reimburse primary care providers (doctors, nurse practitioners, physician assistants, and midwives) at rates no lower than Medicare pays for the same services. It adds obstetrician-gynecologists and advanced practice clinicians to the eligible provider list and extends the floor indefinitely, ensuring primary care providers—especially in rural and underserved areas—receive adequate compensation to maintain access to care for Medicaid patients, including children.
Why we flagged it
The bill renews and expands Medicaid payment rate floors for primary care providers, ensuring reimbursement rates match or exceed Medicare rates. This is substantive healthcare policy affecting provider compensation and access to care.
What the text implies
- Expands eligible provider types (OB/GYN, advanced practice clinicians, rural health clinics, nurse practitioners, and physician assistants) beyond the original 2013–2014 framework, potentially creating inconsistent payment obligations across states that may not have equivalent supervision or licensing structures.
- Self-attestation requirement for board certification eliminates pre-verification gatekeeping and shifts audit burden to states and HHS, creating compliance risk if providers falsely attest but continue receiving enhanced reimbursement indefinitely.
The full analysis lists 5 implications of this text.
Who stands to gain
primary care physicians (family medicine, internal medicine, pediatrics); obstetrician-gynecologists; nurse practitioners and physician assistants