ACP Action Alert - Urge Senators to Support Key Provisions in the Build Back Better Act!

Lawmakers in Congress are in the final stages of negotiating a massive social spending bill known as the Build Back Better Act/BBBA (H.R. 5376). This legislation impacts federal programs across virtually every sector, including making investments in areas of vital interest to ACP, such as expanding health coverage, establishing paid family and medical leave benefits, addressing prescription drug pricing, supporting maternal and behavioral health, improving the physician workforce, and tackling climate change, among others.

On November 19, 2021, the House passed H.R. 5376 and ACP supported many key provisions in that legislation (view ACP letter), which now heads to the Senate for consideration and a possible vote, although the content will likely change due to budget rules in that chamber.  With the 50-50 balance of power in the Senate, the Democrats hold the majority by one vote (Vice President Harris), and getting senators Manchin (D-WV) and Sinema (D-AZ) on board with a final agreement will be key to getting any bill across the finish line and signed into law (so strong engagement from the WV and AZ chapters will be important)!  Both senators are expressing concerns about the overall estimated cost of H.R. 5376, as well as concerns over paid leave, prescription drugs, and other non-health-related policies.

While ACP did not endorse H.R. 5376 in its entirety because of its extensive scope, we need your help to advocate for key provisions in any final agreement that align with ACP policy, some of which were included in the House-passed version of H.R. 5376 or are under consideration:

  • Paid Family and Medical Leave: ACP supports the goal of universal access to family and medical leave policies that provide a minimum period of six weeks' paid leave. H.R. 5376 includes four weeks of paid parental, family caregiving, and medical leave but this provision could be at risk in the Senate.  The United States is currently the only developed country that does not have some form of federal paid leave.
  • Prescription Drug Price Negotiation: ACP supports allowing the federal government to negotiate with manufacturers for lower drug prices for Medicare beneficiaries, including allowing negotiation for 250 brand name drugs that lack competition in the marketplace and establishing a maximum fair price for a bare minimum of 25 of those drugs. H.R. 5376 allows direct government negotiations on some of Medicare's costliest drugs, starting with the 10 most expensive drugs by 2025 and going up to 20 drugs by 2028, and it caps Medicare out-of-pocket prescription drug costs at $2,000, among other things. This provision could be at risk in the Senate.
  • Graduate Medical Education (GME) Slots: ACP supports adding 14,000 new GME positions over seven years and is pleased that H.R. 5376 expands capacity for training the next generation of primary health care “providers” by adding 4,000 additional GME slots.
  • Enhanced Premium Tax Subsidies:  ACP supports efforts to provide temporary enhanced ACA cost-sharing reduction assistance to individuals in the Marketplaces with household incomes below 138 percent of the federal poverty level for calendar years 2022 through 2025. Such a provision was included in H.R. 5376.
  • Closing the Medicaid Coverage Gap: ACP has long supported the Medicaid program as vital in the effort to ensure that this nation’s most vulnerable population has access to health coverage. H.R. 5376 provides access to affordable coverage ($0 premiums) through 2025 to the nearly four million Americans who currently fall within the coverage gap because they live in one of the 12 states that did not expand Medicaid. 
  • Maternal Health: ACP supports extending the postpartum coverage period for individuals who were enrolled in Medicaid while pregnant to a full year after the end of pregnancy.  H.R. 5376 ensures that all pregnant women on Medicaid can keep their health insurance for the first year postpartum, makes significant public health investments to reduce inequities in maternal health outcomes, and strengthens the maternal health workforce.

Action Requested:  Please send a letter to your senators urging them to reach final agreement on the BBBA that can pass both chambers and that includes the vital provisions noted above.  Simply follow the prompts below, and personalize a sample letter to your senators that we have drafted for your convenience. Time is of the essence as the Senate is expected to act on this bill in the coming weeks.

Before you can take action, we need to learn more about you.


We submit your correspondence through officials' contact forms and therefore must provide the information that they require. To ensure that your response is successfully transmitted, please fill out the form above (all fields marked with an *).