I 
111TH CONGRESS 
1ST SESSION H. R. 1296 
To achieve access to comprehensive primary health care services for all Ameri-
cans and to reform the organization of primary care delivery through 
an expansion of the Community Health Center and National Health 
Service Corps programs. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 4, 2009 
Mr. CLYBURN (for himself, Mr. ABERCROMBIE, Mr. BERMAN, Mr. BISHOP of 
New York, Mr. BLUMENAUER, Ms. BORDALLO, Mr. BOSWELL, Mr. BOU-
CHER, Mr. BUTTERFIELD, Mr. CARNEY, Mrs. CHRISTENSEN, Mr. CLAY, 
Mr. COSTA, Mr. DAVIS of Illinois, Mr. DAVIS of Tennessee, Mr. 
DEFAZIO, Ms. DEGETTE, Mr. COOPER, Mr. DELAHUNT, Mr. DOGGETT, 
Mr. ELLISON, Ms. ESHOO, Mr. FILNER, Mr. FRANK of Massachusetts, 
Mr. GRIJALVA, Mr. GUTIERREZ, Mr. HIGGINS, Mr. HINOJOSA, Mr. 
LARSON of Connecticut, Ms. LEE of California, Mr. LEWIS of Georgia, 
Mrs. MALONEY, Mr. MARKEY of Massachusetts, Mr. MEEK of Florida, 
Mr. MOORE of Kansas, Ms. MOORE of Wisconsin, Mr. MORAN of Vir-
ginia, Mr. MURTHA, Mr. NADLER of New York, Mrs. NAPOLITANO, Ms. 
NORTON, Mr. OLVER, Mr. ORTIZ, Mr. PASCRELL, Mr. PASTOR of Ari-
zona, Mr. PAYNE, Mr. PERLMUTTER, Mr. PRICE of North Carolina, Mr. 
RAHALL, Mr. RODRIGUEZ, Mr. ROTHMAN of New Jersey, Ms. ROYBAL- 
ALLARD, Mr. RUSH, Mr. SARBANES, Ms. SCHWARTZ, Mr. SCOTT of Geor-
gia, Mr. SERRANO, Ms. SHEA-PORTER, Mr. SIRES, Ms. SLAUGHTER, Mr. 
SPRATT, Mr. TOWNS, Ms. VELA´ZQUEZ, Mr. WEINER, Mr. WELCH, Mr. 
WEXLER, Mr. WILSON of Ohio, Mr. WU, Mr. YARMUTH, Mr. CLEAVER, 
Mr. FARR, Ms. CLARKE, Mr. SALAZAR, Mr. ROSS, Mr. THOMPSON of 
California, and Ms. SCHAKOWSKY) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To achieve access to comprehensive primary health care serv-
ices for all Americans and to reform the organization 
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of primary care delivery through an expansion of the 
Community Health Center and National Health Service 
Corps programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access for All America 
Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Providing universal coverage for health care 
for all Americans will be incomplete if access to 
medical and other health services is not improved. 
(2) Currently, 56,000,000 Americans, both in-
sured and uninsured, have inadequate access to pri-
mary care due to a shortage of physicians and other 
like providers in their community. 
(3) Several demonstrations are underway at the 
Federal and State level to link patients to a primary 
care ‘‘medical home’’ as a means of assuring access, 
controlling costs, and improving quality. 
(4) Yet, there already exists a proven medical 
home model that accomplishes these goals and has 
done so over the past 40 years while serving over 
18,000,000 Americans. 
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(5) Community health centers, also known as 
Federally Qualified Health Centers (FQHCs), have 
been found to more than pay for themselves by pro-
viding coordinated, comprehensive medical, dental, 
behavioral health, and prescription drug services 
that reduce unnecessary emergency room visits, am-
bulatory-sensitive hospitalizations, and avoidable 
specialty care. 
(6) The result is that the American Academy of 
Family Physicians’ Robert Graham Center found 
that medical expenses for health center patients are 
41 percent lower compared to patients seen else-
where, an average savings of $1,810 per person per 
year. 
(7) The Lewin Group found that providing ac-
cess to a medical home for every American would 
produce health care savings of $67,000,000,000 per 
year, more than 8 times the subsidy needed to sus-
tain the 1,100 current health centers and to create 
3,900 new or expanded health center sites to accom-
plish full access. 
(8) Hand in hand with the expansion of the 
community health center program, a renewed invest-
ment in the National Health Service Corps is essen-
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tial to reverse the decline in the supply of primary 
care physicians and dentists. 
(9) Both the expansion of the community health 
center program and the investment in the National 
Health Service Corps can be accomplished for less 
than 1 percent of total health care spending today. 
(10) Finally, to encourage broader adoption of 
the cost-effective community health center model of 
care beyond underserved areas and populations and 
to encourage the pursuit and practice of primary 
care as a career, all willing primary care practi-
tioners should be encouraged to collaborate with 
community health centers. 
SEC. 3. SPENDING FOR FEDERALLY QUALIFIED HEALTH 
CENTERS (FQHCS). 
Section 330(r) of the Public Health Service Act (42 
U.S.C. 254b(r)) is amended by striking paragraph (1) and 
inserting the following: 
‘‘(1) GENERAL
AMOUNTS
FOR
GRANTS.—For 
the purpose of carrying out this section, in addition 
to the amounts authorized to be appropriated under 
subsection (d), there is authorized to be appro-
priated the following: 
‘‘(A) 
For 
fiscal 
year 
2010, 
$2,988,821,592. 
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‘‘(B) 
For 
fiscal 
year 
2011, 
$3,862,107,440. 
‘‘(C) For fiscal year 2012, $4,990,553,440. 
‘‘(D) 
For 
fiscal 
year 
2013, 
$6,448,713,307. 
‘‘(E) 
For 
fiscal 
year 
2014, 
$7,332,924,155. 
‘‘(F) 
For 
fiscal 
year 
2015, 
$8,332,924,155. 
‘‘(G) For fiscal year 2016, and each subse-
quent fiscal year, the amount appropriated for 
the preceding fiscal year adjusted by the prod-
uct of— 
‘‘(i) one plus the average percentage 
increase in costs incurred per patient 
served; and 
‘‘(ii) one plus the average percentage 
increase in the total number of patients 
served.’’. 
SEC. 4. OTHER PROVISIONS. 
(a) SETTINGS
FOR SERVICE DELIVERY.—Section 
330(a)(1) of the Public Health Service Act (42 U.S.C. 
254b(a)(1)) is amended by adding at the end the fol-
lowing: ‘‘Required primary health services and additional 
health services may be provided either at facilities directly 
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