Support of CHWs Under Federal Health Care Reform

< Back Next >

A CHW talking to some women about healthy behaviors.Support of CHWs under Federal health care reform includes:

  • National Health Care Workforce Commission (§5101)—includes CHWs as primary care professionals
  • Grants to Promote the Community Health Workforce (§5313)—CDC grants:
    • To promote positive health behaviors and outcomes in medically underserved communities
    • Center for Medicare and Medicaid Innovation (CMMI)


The 2010 federal health care reform legislation, called the Patient Protection and Affordable Care Act, or ACA, explicitly mentions CHWs in several places, and other provisions appear to suggest roles for CHWs. We will briefly review some of the more promising ones.

This slide and the next two highlight three areas in the legislation that specifically mention CHWs.

The Affordable Care Act discusses the need to increase the supply of qualified primary care professionals, including CHWs, to meet the needs created when increasing numbers of Americans obtain health insurance coverage. The Secretary of Health and Human Services has appointed a National Health Care Workforce Commission to create a national strategy for addressing this issue. One of the Commission members is a CHW herself, indicating that the administration is taking this part of the workforce very seriously.

For CHWs, one of the most promising sections of the act is the provision for grants to employ CHWs “to promote positive health behaviors and outcomes.” This funding is to be awarded by CDC, but the Affordable Care Act does not directly appropriate funds for such grants. To date there has been no appropriation for this Section of the Act.

The Act also established the Center for Medicare and Medicaid Innovation (CMMI), with its own ten-year appropriation. One signature CMMI program, the Health Care Innovation Challenge Awards, has made over 200 state and local grants, of which about 20 percent have involved CHWs, and CMMI has established a national Grantee CHW Learning Collaborative to help get the most value out of these projects.