Build Back Better: Take Action to Advance Health Equity

In November, the U.S. House of Representatives passed their version of the Build Back Better (BBB) Act. The bill now moves to the Senate, where further adjustments may be made. Here is a summary of the major healthcare and social policies in the current bill. These provisions are critical for advancing health equity, especially for low-income, LGBTQ+, and other marginalized Americans. Tell your Senators today to support the BBB and its vital public health and social support policies.

Important Healthcare Provisions

  • Expanded Home- and Community-based Services through Medicaid:  BBB provides funding for job creation, increased wages, and recruitment and retention for the home and community-based caregiving workforce. Currently, hundreds of thousands of eligible individuals are stuck on long waiting lists for home-based services.
  • Increasing Access to the Affordable Care Act (ACA) Marketplace: BBB extends the ACA premium tax credits established in the American Rescue Plan through 2025, allowing more people to access affordable health insurance.
  • Closing the Medicaid Coverage Gap: BBB expands access to ACA insurance plans for the approximately 2.2 million people who are in the Medicaid “coverage gap,” meaning that their income is too high to qualify for Medicaid but too low for subsidized ACA plans. Research has shown closing the gap through Medicaid expansion has been particularly beneficial for LGBTQ+ populations and people of color.
  • Hearing Services through Medicare: BBB adds coverage of hearing services to Medicare Part B starting in 2023. As one in three aging adults experiences disabling hearing loss, coverage for these services is crucial and will especially benefit low-income Medicare beneficiaries.
  • Paid Family and Medical Leave: Starting in 2024, all US workers will receive paid leave for births, personal illness, or family illness. The provision includes updated family definitions to be inclusive of all families, including LGBTQ+ families.
  • Ending the HIV Epidemic: BBB appropriates an additional $75 million in funding to the Ryan White Program to advance initiatives to end the HIV epidemic and address challenges brought on by the COVID-19 pandemic.
  • Community Health Centers: BBB strengthens the public health safety net by investing $16.2 billion in public health infrastructure and workforce, including $2 billion for community health center capital grants for improvement and modernization of community health centers.

Social Policy Provisions for Advancing Health Equity:

  • Marriage/Tax Recognition: BBB will allow same-sex married couples to claim previously inaccessible tax benefits dating back to 2004, reinforcing that the federal government recognizes same-sex marriages.
  • Families and Children: BBB will expand access to free preschool and affordable childcare. BBB extends the Child Tax Credits from the American Rescue Plan, helping to cut child poverty rates.
  • Housing: BBB aims to address systemic discrimination in housing by making investments in affordable housing programs and expanding the Housing Choice Voucher program.
  • Community Violence Initiatives: BBB funds public health strategies, including community-based violence prevention and mental health services in schools, to address community violence.

As voting on BBB now moves to the U.S. Senate, your Senators need to hear from you! Find your Senator in Congress.


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