Developing the Community Health Workforce Act of 2026
- Sponsor
- Rep. Ruiz, Raul [D-CA-25]
- Committees
- Ways and Means Committee (primary)
- Last action
- Apr 30, 2026
Bottom line
This bill seeks to address healthcare workforce shortages in rural and underserved communities by enhancing recruitment, training, and retention mechanisms for Federally Qualified Health Centers and expanding their service offerings.
What it actually does
This bill aims to bolster the healthcare workforce in underserved areas by expanding eligibility for federal loan repayment programs, creating new grant programs for Federally Qualified Health Centers (FQHCs) and educational institutions to recruit and train staff, and increasing Medicare funding for graduate medical education (GME) programs that partner with FQHCs. It also expands the scope of services FQHCs can bill for under Medicare and Medicaid to include behavioral health professionals and case managers.
Proponents argue
Supporters argue this bill is crucial for addressing critical healthcare workforce shortages, particularly in rural and underserved areas, by making it more attractive for professionals to serve in these communities and by expanding the capacity of FQHCs to provide essential services, including behavioral health. They contend that strengthening the FQHC workforce pipeline will improve access to care and health outcomes for vulnerable populations.
Opponents contend
Opponents might argue that while the goals are laudable, the bill's approach could lead to increased federal spending without sufficient oversight on the effectiveness of new grant programs or the long-term impact on the overall healthcare market. Concerns could also be raised about the potential for administrative burden on FQHCs and educational institutions in implementing these new programs and reporting requirements.
The bill is concise and its provisions are clearly laid out, making it accessible for a quick but informed review.
Section 2(a)
Prioritizing FQHCs and Rural Health Clinics for NHSC Assignments
This provision amends the Public Health Service Act to require the Secretary of Health and Human Services to give priority to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) when approving applications for the assignment of National Health Service Corps members. This means FQHCs and RHCs in health professional shortage areas will have a better chance of receiving NHSC clinicians.
Supporters argue
Supporters argue that directing NHSC resources to FQHCs and RHCs is a highly effective way to ensure that healthcare professionals are placed directly into the communities most in need, maximizing the impact of the program.
Critics contend
No specific opposition is typically raised against prioritizing FQHCs and RHCs for NHSC assignments, as these entities are widely recognized for serving vulnerable populations.
Tradeoffs
This provision prioritizes FQHCs and RHCs over other types of health professional shortage areas, potentially shifting NHSC resources from other deserving sites.
Section 2(b)
Grants for FQHC-Administered Loan Repayment Programs
This section authorizes the Secretary of Health and Human Services to award grants directly to Federally Qualified Health Centers. These grants are specifically for FQHCs to make loan repayments on behalf of healthcare professionals who serve at their centers, aiming to address local workforce shortages. Applications must detail the center's capacity, repayment plan, and use of interdisciplinary care.
Section 3(a)
Grants for Health Center Workforce Recruitment, Training, and Retention
This provision authorizes the Secretary to award grants directly to health centers to help them recruit and hire staff with the necessary skills to serve rural and underserved patient populations. It also supports career advancement and workforce development opportunities for existing staff, aiming to build a stable, community-based health workforce.
Section 3(b)
FQHC Eligibility for Registered Apprenticeship Programs
This section mandates the Secretary of Labor to revise regulations within 180 days of enactment to make Federally Qualified Health Centers (FQHCs) eligible to register as apprenticeship programs. This would allow FQHCs to formally participate in the national apprenticeship system, providing structured on-the-job training and related instruction for various healthcare roles.
Section 3(c)
Grants for Higher Education Partnerships with Health Centers for Student Training
This provision authorizes grants to institutions of higher education, including community colleges and minority-serving institutions, to establish partnerships with health centers. The purpose of these partnerships is to train students in health professions, covering costs like clinician salaries, and offering various types of training such as clinical, IT, operations, and finance.
Section 3(d)
Grants for Behavioral Health Specialist Training Programs
This provision authorizes grants to health centers specifically for establishing, operating, or expanding training programs for behavioral health specialists. These programs can include stipends for personnel, apprenticeship programs, and other recruitment and retention activities, aiming to increase the availability of behavioral health services in underserved areas.
Section 4(a)
Including Covered Agreements for Teaching Health Center GME Payments
This provision amends the Public Health Service Act to allow payments to Teaching Health Centers (THCs) for graduate medical education (GME) even if they don't directly sponsor the residency program, as long as they have a 'covered agreement' (a 2-year written contract) with a sponsoring institution. This expands the flexibility for THCs to participate in GME, effective October 1, 2025.
Section 4(b)
Medicare GME Cap Increase for Hospitals Partnering with FQHCs
This provision amends the Social Security Act to increase the Medicare Graduate Medical Education (GME) resident cap for hospitals by 3 full-time equivalent (FTE) residency positions. This increase applies to hospitals that have an approved medical residency training program where a 'significant portion' of the program occurs at a Federally Qualified Health Center (as determined by the Secretary). This change is effective for cost reporting periods beginning on or after October 1, 2025.
Section 5(a)
Medicare and Medicaid Coverage for FQHC Behavioral Health and Case Management Services
This provision expands the definition of 'Federally Qualified Health Center services' under Medicare and Medicaid to include services furnished by behavioral health consultants, peer support specialists, other behavioral health professionals, and case management services. This means FQHCs can bill for these services, increasing access to integrated care, effective October 1, 2025.
Section 5(b)
HHS Study and Guidance on State Medicaid FQHC Payment Adjustments
This provision requires the Secretary of Health and Human Services to conduct an annual study, starting October 1, 2025, on how different State Medicaid plans adjust payments to FQHCs. Based on these studies, the Secretary must issue guidance to State plans on best practices for adjusting FQHC payment amounts. This aims to promote consistency and fairness in Medicaid FQHC reimbursement.
The bill expands Medicare and Medicaid coverage for FQHC services to include those furnished by 'a behavioral health consultant, peer support specialist, or other behavioral health professional (as such terms are defined by the Secretary)' and 'case management services furnished... by a case manager (as defined by the Secretary).'
Section 5(a)(1)(A)(i) and (iv)
Why it matters:This is standard legislative practice to allow for administrative flexibility and expert input in defining technical terms that may evolve. However, it means the full impact of the provision is not immediately clear from the bill itself.
Case for: Proponents argue that delegating these definitions to the Secretary allows for greater adaptability to evolving clinical practices and workforce models, ensuring that the definitions remain current and effective without requiring further legislative action. It also allows for expert input from relevant professional bodies.
Case against: Critics might contend that leaving these definitions to the Secretary creates uncertainty for FQHCs and providers regarding what services will be reimbursable and could lead to delays in implementation. It also shifts significant policy-making power to the executive branch, potentially reducing congressional oversight on the precise scope of expanded services.
Estimated impact: The ultimate fiscal impact and the extent of improved access to care will depend heavily on how broadly or narrowly the Secretary defines these roles and services.