The House of Representatives voted to pass President Joe Biden’s $1.75 trillion Domestic policy agenda Friday, including the historic expansion of the Affordable Care Act, investment in the healthcare workforce, and funding for pandemic preparations.

The plan is now moved to the Senate and requires 51 votes to pass. Given that the Democrats passed with a weak majority, they have no room for error. Biden has said that after talking with the main senator, he believes it can pass the upper house.

The House of Representatives passed 220 votes to 213, marking the victory of the President, who has been trying for months to win more moderate party members who want to reduce spending bills.The version of the “Rebuild Better Act” that passed the House of Representatives today is Scale down A significant reduction of $3.5 trillion has reduced several healthcare priorities lobbied by providers and advocates.

Nevertheless, if passed by the Senate, the plan will expand ACA subsidies to millions of people by 2025. This includes 2.2 million people.Cover the gap“Because they live in 12 states that have not expanded Medicaid under the ACA and states with incomes four times higher than the federal poverty level. The legislation will also make subsidy Be more generous to low- and middle-income people, and those who are in the coverage gap will be eligible for a zero premium policy, and health insurance exchanges have the least cost-sharing.

Senate Majority Leader Chuck Schumer (DN.Y.) said in a statement on Friday: “We will take action as soon as possible to submit this bill to President Biden and provide assistance to middle-class families.”

Biden expands access to health care and builds on ACA by expanding insurance coverage to people who have been turned away since the law came into effect in 2010, and making the exchange program more affordable through larger subsidies .

The expansion of ACA subsidies is a victory for providers, especially in rural areas where hospitals face higher levels of unpaid care. However, as a trade-off for those who extend coverage to cover gaps, the plan will also reduce payments to help hospitals pay for unpaid care costs.

The hospital has urged Congress to remove from the package will reduce Disproportionate shared hospitals Pay 12.5% ??and cut funds Free nursing pool In states that have not yet expanded the Medicaid program. According to the Congressional Budget Office, these cuts will save the government $35 billion in 10 years.

“While we appreciate the goal of increasing coverage for residents of states that have not expanded Medicaid, it should not be at the expense of important funding for hospitals and health systems in areas that serve large numbers of children, the poor, and the disabled. People and the elderly,” Rick Pollack, president and chief executive officer of the American Hospital Association, said in a statement on Friday. “These cuts are unacceptable, especially when hospitals are still on the front lines of the fight against COVID-19 and the deadly variant of Delta.”

expert contend As the coverage under the bill expands, suppliers in non-expanded states will receive a net benefit, albeit with a reduction. But the provider pointed out that the expanded ACA subsidy is temporary, while the DSH and unpaid care pool changes are permanent.

These cuts may not survive the Senate, and members including Georgia Democrats Senators Rafael Warnock and Jon Osoff oppose them.

Pollack also expressed disappointment that the final version of the House bill cut $10 billion in funding for hospital infrastructure improvements.

The package includes other major wins for hospitals, including medical insurance-funded new residency places in 4,000 medical schools, the largest increase since the 1990s.

“We strongly support and appreciate the historic increase in doctor training funding, which will benefit patients across the country, especially those in the areas most affected by the shortage of doctors,” said David Scott, president and CEO of the American Association of Medical Colleges. Denton and Chief Public Policy Officer Karen Fisher said in a statement.

Other notable provisions of the bill include:

• US$3.4 billion was used for postgraduate medical education in teaching health centers, and US$200 million was used for Genetically modified organisms Children’s Hospital Project
• US$2 billion for the National Health Service Corps and US$500 million for the Nurse Corps, which provides scholarships and loan repayments to providers and nurses working in underserved areas
• US$500 million each for nursing and medical schools in underserved areas
• Medical insurance covering hearing services from 2023
• The package will direct the Ministry of Health and Human Services negotiated price Cooperate with pharmaceutical companies on a small number of high-cost drugs without competitor to generic drugs or biosimilars. If drug prices rise more than inflation, drug manufacturers will be required to pay rebates to the federal government.According to medical insurance and private health plans, the cost sharing of insulin products will be limited to no more than $35
• The Medicaid plan will need to expand the coverage for one year after delivery to reduce Maternal deathThe states currently only need to provide insurance for 60 days postpartum for mothers.The package also includes approximately US$1 billion in grants for entities that address differences in maternal mortality and health outcomes
• $150 billion to expand family and community services for Medicaid
• The bill permanently extends the children’s health insurance plan, which currently needs to be periodically reauthorized by Congress
• US$2 billion is used for capital projects of community health centers, but no funds are used to improve the hospital’s infrastructure
• Provide US$7 billion to the Centers for Disease Control and Prevention to support public health infrastructure