Healthcare (Primary Care · Children)

HR 1433, the Kids’ Access to Primary Care Act of 2025, sets a minimum Medicaid payment rate of 100% of Medicare’s rate for primary care services provided to children. It directly affects Medicaid-covered children and expands eligibility for providers to include pediatricians, family medicine physicians, nurse practitioners, physician assistants, certified nurse-midwives, and rural health clinics or Federally-qualified health centers (FQHCs) under specific conditions. Key provisions require Medicaid managed care plans to pay these providers at the minimum rate, with documentation requirements to verify compliance, and exclude emergency department services from the definition of primary care. The bill also mandates a study to track enrollment and payment rate changes across states after implementation.