Congress Introduces the Community Health Worker Access Act

PIH-supported legislation will strengthen community health workforce

Posted on Mar 7, 2024

Today, Senator Bob Casey (D-Pa.) introduced the Community Health Worker Access Act, a new bill proposing crucial investments in the community health workforce to improve health care access in the United States.

The Community Health Worker Access Act aims to enhance access to health services for Medicare and Medicaid enrollees by improving reimbursement for services provided by community health workers under Medicare and facilitating their integration into Medicaid.

Including community health worker services within Medicare and Medicaid would improve the health of people enrolled in these programs and keep our communities healthy, as demonstrated by community health workers’ years of impact on health care in the U.S. and worldwide. This bill will also help strengthen the community health workforce by providing more sustained sources of funding within the health care system.

The Community Health Worker Access Act is supported by over 270 community health worker networks and public health organizations, including Partners In Health. Partners In Health is adapting lessons learned from our experience around the world to bolster equity-centered public health systems in the U.S. by investing in community health workers.

Below, we explain why this legislation is important and how you can take action.

Remind me, what is Medicare and Medicaid?

Medicare is a nationwide health insurance program for people 65 or older and some people under 65 with certain disabilities or conditions. Medicaid is a public health insurance program that provides coverage for more than 1 in 5 Americans, including eligible adults with low incomes, children, pregnant women, elderly adults, and people with disabilities. Together, these programs provide health coverage for millions of people and are influential sources of public funding for health services.

How will the Community Health Worker Access Act enhance these programs?

The Community Health Worker Access Act would improve payment eligibility for community health workers, promotoras de salud (a Spanish term used to describe community health workers), and community health representatives (a title for community health workers in tribal communities) who provide services to individuals receiving insurance through Medicare and Medicaid while expanding access to community-based services for enrollees in these major health programs.

This bill would provide coverage for two new categories of community health worker services in Medicare:

Services to prevent illness, reduce physical or mental disability, and restore an individual to the best possible functional level
Services to address social needs through education and referrals to health care and community-based organizations.

Currently, community health worker services are an optional benefit in Medicaid that at least 29 states have begun to offer. This bill would require the U.S. Centers for Medicare and Medicaid Services to provide guidance to states to support expanded access to community health worker services. It would also unlock additional federal resources for states to expand these services through Medicaid.

Why is this legislation important?

Decades of evidence has shown that community health workers are effective at improving health outcomes by providing services tailored to a community’s needs, in a way that is relevant to them. In the U.S., community health workers serve as essential connectors between communities and medical services and have been key to improving chronic disease control and mental health, promoting healthy behaviors, and reducing hospitalizations. They are particularly effective in rural and underserved areas where access to medical care is less accessible.

Despite growing recognition of community health workers’ critical role and impact in the U.S., the workforce has struggled with inadequate and unstable funding. Congress has passed significant temporary investments on a bipartisan basis, but there is a need for sustained funding to support community health workers and to better integrate their unique strengths into health care systems.

Covering community health worker services in Medicare and Medicaid will promote health equity by improving care coordination, culturally responsive care, and connections to services.

How did PIH contribute to this legislation?

PIH and our partners at the National Association of Community Health Workers (NACHW) were invited to offer feedback on the draft bill, and we worked with Senator Casey’s team and partners to ensure the final bill reflected the needs identified by community health workers. Our policy paper on sustained Medicaid funding for community health workers helped inform our recommendations.

PIH Engage, a grassroots organizing network of PIH supporters working to build a movement for the right to health, has advocated to build policymaker support for the Community Health Worker Access Act. In August, 160 PIH Engage leaders representing 80 local teams from across the U.S. came together in Washington, D.C., and met with the offices of 100 U.S. senators and representatives to kick off a year of advocacy engagement for global and domestic health policy priorities, including the Community Health Worker Access Act.

PIH and NACHW wrote and circulated a sign-on letter, which was signed by over 200 national, state, and local organizations asking Congress to move the Community Health Worker Access Act forward. A sign-on letter is an advocacy tool where several organizations sign a letter to demonstrate their shared support for a policy. Because PIH-US works alongside so many community partners, we were able to show broad support for this legislation.