Dear ACH Member,

It’s that time of year again - it’s dark by 5:00 pm, the end-of-year deadlines are rapidly approaching, and the holiday season is right around the corner! It’s fitting that the election wraps up between Halloween and Thanksgiving – the anticipation and anxiety of electoral politics that coincide with costumes and horror movies are replaced with the comfort of friends, family, and Thanksgiving feasts, as well as the surge of motivation to continue our advocacy efforts on behalf of health centers and the communities they serve. 

Please continue reading for important member information and legislative updates below.

*Register Now!*

ACH’s 4th Annual Member Meeting (AMM) will be held in Washington, D.C., at the Dupont Royal Sonesta Hotel from March 25 - 27, 2025. Registration is now open! Register before February 28 to take advantage of early bird pricing.

Next week, we are holding a special Members-Only Office Hours on November 20th, at 12:00 (ET) on Fiscal Year 2026 Congressional Directed Spending (Earmarks) to provide one-on-one support and guidance on submitting proposals to your members of Congress. This hour will also be an open opportunity to answer questions more broadly about any current or future Congressional Directed Spending requests your organization may be interested in seeking. 

We will have many additional post-election updates and what they mean for ACH’s administrative and legislative strategies in our weekly Friday Post-Election Policy Updates. In the meantime, we hope you join us for an exclusive, members-only webinar on December 3rd titled “Postmortem on the Presidential Election and its Impact on Community Health Centers.” During this webinar, ACH’s health policy experts will discuss what we know, what remains uncertain, and how potential policy reforms could affect health centers nationwide. We encourage you to register here and invite your team members to join the conversation!  

This week, we kicked off our 340B Learning Collaborative in-person with 12 ACH members! This is the third learning collaborative we’ve offered ACH members and the largest by participation so far. We hope that participants walk away equipped with tangible 340B knowledge to enact change in their communities. 

The Latest News from D.C.

The House and Senate were in session this week. Newly elected members came to D.C. for orientation, and President-elect Trump arrived in D.C. to meet with President Biden and Republican members of the House and Senate. While their meeting was largely private, Trump and Biden have called for a smooth transition and peaceful power transfer. President-elect Trump has also started announcing key posts in his administration, including a handful of sitting GOP Senators and Representatives, which ACH will break down further in our Friday post-election email. Of note is that an HHS secretary nominee has yet to be announced.

While there are still a handful of races to be called, on Wednesday, House Republicans won enough seats, 218, to secure the majority. In the Senate, Senator Bob Casey (D-PA) has yet to concede his seat to David McCormick (R-PA), and the vote margin is .4% - enough to trigger the state’s automatic recount. The AP called the seat for McCormick last week, and Senator Schumer invited McCormick to Senate orientation this week, but this seat may take a couple of weeks to know for sure.

Republicans held leadership races in the Senate and House. The House Republican Conference nominally elected current Speaker Mike Johnson as the 119th Congress Speaker nominee. Rep. Steve Scalise (R-LA) retained his seat as House Majority Leader, Rep. Tom Emmer (R-MN) retained his seat as Whip, and Rep. Lisa McClain (R-MI) was elected over Rep. Kat Cammack (R-FL) to replace Rep. Elise Stefanik (R-NY) as Conference Chair.

In a contested race to replace Sen. Mitch McConnell (R-KY) as Senate Majority Leader, Republican Senators held a secret ballot voting between Sens. Rick Scott (R-FL), John Thune (R-SD) and John Cornyn (R-TX). After the first round of voting, Senator Scott was removed from the ballot, and in the second round, Senator Thune beat Senator Cornyn by a vote of 29-24, making him the next Senate Majority Leader. Thune is largely seen as an establishment Republican choice, while Senator Scott was favored by incoming President Trump and his allies.

Updates on ACH Priorities and Legislation

CHC Invest 

• ACH is meeting with leadership and key members in the House and Senate on both sides of the aisle to discuss the importance of reauthorizing the CHC Trust Fund at increased, sustainable levels. As a reminder, the CHC Fund authorization expires on December 31, 2024. While the feedback has been generally positive, and we do not expect Congress to let the authorization expire, the lame-duck session and incoming transition of the Trump Administration, as well as incoming Republican majorities in the House and Senate, create obvious uncertainties about the potential for significant increases during this lame duck period. ACH will continue to meet with leadership and committee staff to advocate for the highest possible funding levels.
• Funding Letters: 
  • This Fall, ACH delivered a letter to congressional leaders and key staff urging Congress to reauthorize the Community Health Center Fund in an end-of-year funding package with sustained, long-term funding. The letter, signed by more than 550 healthcare organizations representing all 50 U.S. States and territories, specifically requested a minimum of $5.8 billion per year for at least three years. 
  • This month, the Association of Clinicians for the Underserved and the American Association of Teaching Health Centers led a letter to leaders on the Hill requesting funding levels for the NHSC and THCGME programs to be funded at the levels passed by the Senate HELP Committee in the Bipartisan Primary Care and Health Workforce Act. Advocates for Community Health signed the letter. More information can be found here. 

340B/C

• ACH Special Report on The Critical Role of 340B at FQHCs: ACH released a special report this month in a targeted campaign on how health centers are utilizing 340B savings in their communities. *Thank you to Denver Health and Great Lakes Bay Health Centers for providing information for this report!* Read the report here.
• SUSTAIN: While the status of the SUSTAIN 340B Act’s introduction remains nebulous, we believe it is highly unlikely that there will be significant (or any) Committee action in the House or Senate regarding 340B reform before the new Congress. However, with one of SUSTAIN’s authors, Senator Thune (R-SD), newly elected as Senate Majority Leader, we could see introduction as a marker bill before the end of the year. ACH will continue meeting with Congress to push policy changes to protect the 340B program for health centers and lay the groundwork for the 119th Congress to view 340B reform as a non-negotiable priority.
• 340B PATIENTS Act: On September 11, Senator Peter Welch (D-VT) introduced the Senate’s version of the House 340B PATIENTS Act. ACH endorsed the bill, thanking Senator Welch for sponsoring this legislation codifying the use of contract pharmacies to dispense 340B discounted drugs. See the Senator’s press release here, with comments from ACH’s CEO Amanda Pears Kelly and Bi-State Primary Care Association’s Tess Kuenning.
• In the States: Bloomberg Law has highlighted 340B as a legal theme to watch in 2025. Their analysis includes recent court rulings about contract pharmacies and the debate over federal versus state power within the 340B program. As of November 2024, over half of the 50 states have introduced 340B contract pharmacy legislation, with six states enacting new laws this year, and at least 28 lawsuits have been filed against these states by the manufacturers.
• Rebate Model: This week, Johnson and Johnson filed a lawsuit against HRSA regarding the agency’s final decision regarding J&J’s “Transparency Rebate Model.” With the change in Administration and President-elect Trump’s distaste for regulatory burden, it remains to be seen how this lawsuit eventually pans out. 

Value-Based Care

• The ACH VBC Working Group met last week with the Duke Margolis Institute for Health Policy to discuss their recent report, “Experiences and Interest in Value-Based Payment Arrangments for Medical Products Among Medicaid Agencies: An Exploratory Analysis." The working group was asked to provide information to enhance their research, such as their experiences with VBP arrangements or which entities Duke Margolis should include in their future work to inform their studies and recommendations. For additional information or to provide specific feedback, please contact Molly Grady. 
• As a reminder, ACH compiled an extensive list of VBC materials and resources exclusively for our members. We hope you find this helpful, and we look forward to continuing to expand our role and influence in creating value-based care arrangements that benefit health centers and the patients they serve. 

Health Equity

• Advocates for Community Health and the National Association of Rural Health Clinics (NARHC) sent a letter to leadership in the House of Representatives to encourage them to pass the Telehealth Modernization Act (HR 7623). This bill would extend certain telehealth flexibilities initially authorized during the Covid-19 Public Health Emergency. 
• *ACTION ITEM* ACH has launched a new grassroots initiative to re-engage with Members of Congress on H.R. 1072, the Health Center Community Transformation Hub Act, introduced by Rep. Yvette Clarke (D-NY). The bill will require re-introduction next Congress, so ACH is working to build more robust support on the Hill now. Thank you in advance for your efforts, and please let us know if you have any questions!

FQHC Workforce

• The ACH-led Developing the Community Health Workforce Act, soon to be introduced by Congressman Raul Ruiz (D-CA), has been finalized by the House’s Legislative Counsel, and we are actively working to find a Republican co-sponsor. We have several leads, but please contact Molly Grady at mgrady@advocatesforcommunityhealth.org if you have a Republican office you are close with that you think might be interested in working with us on this bill.

 Emergency Preparedness

• ACH has continued to work with Rep. Nanette Barragan's office (D-CA) to introduce the Emergency Preparedness for Underserved Populations Act. We hope to identify a Republican co-sponsor and introduce the bill before the end of the year. 
• The ACH Emergency Preparedness Work Group met this week to discuss ACH’s ongoing work on the Hill and with the Administration and future priorities for the group. For current members, we will schedule a 2025 strategic planning call in the New Year, likely in late February/Early March. 
• ACH has had several conversations with key congressional and Administrative staffers about including health center-specific funding in the end-of-year Emergency Supplemental funding bill. We are also exploring the creation of a fund for future appropriations for HRSA explicitly dedicated to community health centers in the wake of natural disasters and other mass casualty events.

Other News from Across the Federal Government 

The White House

• Rural Health Access: The Biden Administration’s efforts to strengthen access to health care have been linked to historic gains in rural America’s health insurance coverage, as evidenced in a report recently released by HHS’ Office of the Assistant Secretary for Planning and Evaluation (ASPE).
• Maternal Health Task Force: In celebration of the one-year anniversary of the Biden Administration’s Task Force on Maternal Mental Health, HHS is calling for information on new initiatives from organizations that could improve maternal health and substance use disorder nationwide. To prepare for discussion, they are asking that organizations submit a pledge to TFMMH@hhs.org by December 6th and include target dates, metrics, and estimates on the number of people the new work will serve. 

Health Resources and Services Administration

• Rural Health Day: Thursday, November 21st, is National Rural Health Day. This year's theme is “Advancing Maternal Health in Rural Communities.” Visit HRSA’s National Rural Health Day Agenda webpage for additional information.
• NHSC National Advisory Council: HRSA is still looking for members to join the National Advisory on the National Health Service Corps to help address healthcare delivery needs in underserved areas. Clinicians and health officials with a background in primary care, oral health, or mental/behavioral health are encouraged to apply. The deadline for submitting nominations, including self-nominations, is December 6.

Centers for Medicaid and Medicare Services

• Reimagining Rural Health: This week, CMS published a report describing lessons learned from CMMI rural health models, potential areas to explore in the future, and themes and insights gained from the 2024 Rural Health Hackathon. 
• Improving Rural Health: Join CMMI for a person-centered listening session on improving care experience, outcomes, & equity in rural communities. Insights from the session will help inform future strategies to address rural health issues. The listening session will take place on Wednesday, November 20 from 12:00-1:00 ET. Register Here. 
• 2025 Physician Fee Schedule Final Rule: This month, CMS announced it is finalizing new policies in the 2025 Medicare Physician Fee Schedule final rule to strengthen primary care, expand access to preventative services, and increase access to behavioral health, oral health, and caregiver training. The final rule also aims to preserve limited flexibilities within CMS’ authority of telehealth coverage. Advocates for Community Health commented on this rule, which can be found here.
• Rural-Urban Health Disparities: CMS’ Office of Minority Health released a new report on health care received by people with Medicare nationwide. The report highlights the rural-urban differences in health care experiences, how they differ by race and ethnicity, and historical trends in quality of care. The report is based on the Healthcare Effectiveness Data and Information Set (HEDIS) and the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
• Medicare Open Enrollment: Medicare-eligible beneficiaries can join, switch, or drop a Medicare Advantage (Part C) or Medicare drug plan (Part D) through December 7th.
• (Reminder) Marketplace Open Enrollment Period: The open enrollment period on HealthCare.gov begins November 1st and ends January 15th, 2025. CMS announced a handful of policies this week to increase access and affordability of coverage. For the first time, DACA recipients will have access to marketplace coverage. CMS has also launched “window-shopping” for consumers to preview health coverage options before selecting a plan.

ICYMI

• Hospitals Adjust as Rates of Maternal High Blood Pressure Spike, KFF Health News
• The Sickest Patients are Fleeing Private Medicare Plans - Costing Taxpayers Billions, The Wall Street Journal
• Primary Care Practice Telehealth Use and Low-Value Care Services, JAMA
• Supplemental Reading: No Link Between Telehealth and Low-Value Services in Primary Care, Health Care Drive
• Open AI isn’t Built for Health Care. So Why Is Its Tech Already in Hospitals, Pharma, and Cancer Care? Stat News
• An Open Letter to the Next Administration Regarding Primary Care, Medpage Today
• Community Health Centers Face Funding Crisis, Business NH Magazine

Upcoming Events of Interest

• November 19: Health Insurance for DACA Recipients, presented by the National Immigration Law Center, United We Dream, and Young Invincibles, 3:00 - 3:30 PM (ET), Virtual.
• November 20:  ACH Members-Only Special Policy Office Hours: Expert Assistance on Congressional Directed Spending Requests 12:00 - 1:00 PM (ET), Virtual.
• November 21: “The Role of State Policy in Driving Behavioral Health Measurement, Quality Improvement, and Cost Control”, presented by the Association for Behavioral Health and Wellness, 2:00 - 3:00 PM (ET), Virtual. 
• December 3: ACH Webinar: “Postmortem on the Presidential Election and its Impact on Community Health Centers.” 12:00 - 1:00 (ET), Virtual.
• December 2-4: Third Annual Social Determinants of Health Policy Forum, Washington, D.C.
• March 25-27, 2025: ACH 4th Annual Member Meeting, Washington, D.C.

Please let us know if you have any questions, and have a great rest of your week!

Sincerely,

Your ACH Policy & Government Affairs Team:

Stephanie Krenrich, SVP, Policy & Government Affairs

Molly Grady, Director, Policy & Government Affairs