S.760 - Kids’ Access to Primary Care Act of 2025 (119th Congress)
Summary
S.760, the Kids’ Access to Primary Care Act of 2025, aims to amend Title XIX of the Social Security Act. The primary goal is to renew and expand the application of Medicare payment rates to primary care services under Medicaid. This includes extending the payment floor to additional providers such as OB/GYNs and advanced practice clinicians.
Expected Effects
The Act seeks to improve access to primary care for children enrolled in Medicaid by increasing payment rates to providers. It also mandates a study to assess the impact of these changes on enrollment, provider participation, and payment rates. Managed care entities would be required to ensure payments to healthcare providers meet the specified levels.
Potential Benefits
- Increased access to primary care for children enrolled in Medicaid.
- Higher payment rates may incentivize more providers to accept Medicaid patients.
- Inclusion of additional provider types (OB/GYNs, advanced practice clinicians) expands care options.
- Improved targeting of primary care by excluding emergency department services.
- Study to assess the impact of the Act, allowing for data-driven adjustments.
Potential Disadvantages
- Increased costs to the Medicaid program, potentially straining state budgets.
- Potential administrative burden for providers to self-attest board certification.
- Possible complexity in ensuring compliance by managed care entities.
- The Act authorizes appropriations of $200,000 for the study, which may be insufficient.
- The focus on payment rates may not address other barriers to access, such as transportation or cultural factors.
Most Disadvantaged Areas:
Constitutional Alignment
The bill aligns with the General Welfare Clause (Article I, Section 8) of the Constitution, which allows Congress to provide for the general welfare of the United States through programs like Medicaid. The expansion of healthcare access for children can be seen as promoting the general welfare. The bill does not appear to infringe upon any specific constitutional rights or limitations.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).