,,ii  #aaeth ,,congress  #ast ,session  
,s4 #adda  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bf1     
#bjag,mr4 ,sanders 7for himself1 ,ms4   
,warren1 and ,ms4 ,harris7 introduced   
the following bill2 which was read twice
 and referred to the ,committee on      
,health1 ,education1 ,labor1 and        
,pensions  ,a ,,bill  ,to provide       
funding for ,federally ,qualified       
,health ,centers1 the ,national ,health 
,service ,corps1 ,teaching ,health      
,centers1 and the ,nurse ,practitioner  
,residency ,training program4  #a4      
,short title ,this ,act may be cited as 
the ,community ,health ,center and      
,primary ,care ,workforce ,expansion    
,act of #bjag4  #b4 ,community health   
center program  7a7 ,in general ,section
 #ajejc7;b77#a7 of the ,patient         
,protection and ,affordable ,care ,act  
7#db ,u4,s4,c4 #bed;b-#b7;b77#a77 is    
amended--  7#a7 in subparagraph 7,d71 by
 striking and at the end2  7#b7 in      
subparagraph 7,e71 by striking 2 and2   

and  7#c7 by adding at the end the      
following3  7,f7 #e1aaj1jjj1jjj for     
fiscal year #bjah2  7,g7 #e1daj1jjj1jjj 
for fiscal year #bjai2  7,h7            
#e1gij1jjj1jjj for fiscal year #bjbj2   
7,i7 #f1fbj1jjj1jjj for fiscal year     
#bjba2  7,j7 #g1eaj1jjj1jjj for fiscal  
year #bjbb2  7,k7 #h1dfj1jjj1jjj for    
fiscal year #bjbc2  7,l7 #i1dij1jjj1jjj 
for fiscal year #bjbd2  7,m7            
#aj1eij1jjj1jjj for fiscal year #bjbe2  
7,n7 #aa1ghj1jjj1jjj for fiscal year    
#bjbf2  7,o7 #ab1ejj1jjj1jjj for fiscal 
year #bjbg2 and  7,p7 for fiscal year   
#bjbh1 and each subsequent fiscal year1 
the amount appropriated for the         
preceding fiscal year adjusted by the   
product of--  7i7 one plus the average  
percentage increase in costs incurred   
per patient served2 and  7ii7 one plus  
the average percentage increase in the  
total number of patients served2 and  4 
7b7 ,capital projects ,in addition to   
amounts otherwise appropriated under    
section #ajejc7;b7 of the ,patient      

,protection and ,affordable ,care ,act  
7#db ,u4,s4,c4 #bed;b-#b7;b771 there is 
authorized to be appropriated1 and there
 is appropriated1 for the community     
health centers program under section    
#ccj of the ,public ,health ,service    
,act 7#db ,u4,s4,c4 #bed;b7 for capital 
projects1 #ah1fjj1jjj1jjj for fiscal    
year #bjag4  7c7 ,limitation ,amounts   
otherwise appropriated for community    
health centers may not be reduced as a  
result of the appropriations made under 
this section4  7d7 ,availability of     
funds ,amounts appropriated under this  
section shall remain available until    
expended4  #c4 ,national ,health        
,service ,corps  7a7 ,in general        
,section #ajejc7;b77#b7 of the ,patient 
,protection and ,affordable ,care ,act  
7#db ,u4,s4,c4 #bed;b-#b7;b77#b77 is    
amended--  7#a7 in subparagraph 7,d71 by
 striking and at the end2  7#b7 in      
subparagraph 7,e71 by striking the      
period2 and  7#c7 by adding at the end  
the following3  7,f7 #hej1jjj1jjj for   

fiscal year #bjah2  7,g7 #hic1jjj1jjj   
for fiscal year #bjai2  7,h7            
#ich1jjj1jjj for fiscal year #bjbj2     
7,i7 #ihe1jjj1jjj for fiscal year #bjba2
  7,j7 #a1jcj1jjj1jjj for fiscal year   
#bjbb2  7,k7 #a1jij1jjj1jjj for fiscal  
year #bjbc2  7,l7 #a1ajj1jjj1jjj for    
fiscal year #bjbd2  7,m7 #a1bjj1jjj1jjj 
for fiscal year #bjbe2  7,n7            
#a1cjj1jjj1jjj for fiscal year #bjbf2   
7,o7 #a1ejj1jjj1jjj for fiscal year     
#bjbg2 and  7,p7 for fiscal year #bjbh1 
and each subsequent fiscal year1 the    
amount appropriated for the preceding   
fiscal year adjusted by the product of--
  7i7 one plus the average percentage   
increase in the costs of health         
professions education during the prior  
fiscal year2 and  7ii7 one plus the     
average percentage change in the number 
of individuals residing in health       
professions shortage areas designated   
under section #ccc of the ,public       
,health ,service ,act during the prior  
fiscal year1 relative to the number of  

individuals residing in such areas      
during the previous fiscal year4  4  7b7
 ,limitation ,amounts otherwise         
appropriated for ,national ,health      
,service ,corps may not be reduced as a 
result of the appropriations made under 
this section4  7c7 ,availability of     
funds ,amounts appropriated under this  
section shall remain available until    
expended4  #d4 ,teaching ,health        
,centers  7a7 ,in general ,section      
#cdj;,h7g7 of the ,public ,health       
,service ,act 7#db ,u4,s4,c4 #bef;h7g77 
is amended--  7#a7 by striking #bjae and
 and inserting #bjae12 and  7#b7 by     
striking the period and inserting 1     
#agf1jjj1jjj for fiscal years #bjah and 
#bjai1 #ahd1jjj1jjj for fiscal year     
#bjbj1 #aid1jjj1jjj for fiscal year     
#bjba1 #bjc1jjj1jjj for fiscal year     
#bjbb1 #bad1jjj1jjj for fiscal year     
#bjbc1 #bbd1jjj1jjj for fiscal year     
#bjbd1 #bce1jjj1jjj for fiscal year     
#bjbe1 #bdg1jjj1jjj for fiscal year     
#bjbf1 #bfj1jjj1jjj for fiscal year     

#bjbg1 and for fiscal year #bjbh1 and   
each subsequent fiscal year1 the amount 
appropriated for the preceding fiscal   
year adjusted by the greater of the     
annual percentage increase in the       
medical care component of the consumer  
price index for all urban consumers     
7,u4,s4 city average7 as rounded up in  
an appropriate manner1 or the percentage
 increase for the fiscal year involved  
under section #b7;a77#aa744  7b7        
,limitation ,amounts otherwise          
appropriated for ,teaching ,health      
,centers may not be reduced as a result 
of the appropriations made under this   
section4  7c7 ,availability of funds    
,amounts appropriated under this section
 shall remain available until expended4 
#e4 ,nurse ,practitioner ,residency     
,training ,programs  7a7 ,in general    
,section #ecaf of the ,patient          
,protection and ,affordable ,care ,act  
is amended by striking subsection 7i7   
and inserting the following3  7i7       
,appropriations ,in addition to amounts 

otherwise appropriated1 there is        
authorized to be appropriated1 and there
 is appropriated to carry out this      
section--  7#a7 #ce1jjj1jjj for fiscal  
year #bjah2  7#b7 #dj1jjj1jjj for fiscal
 year #bjai2  7#c7 #de1jjj1jjj for      
fiscal year #bjbj2  7#d7 #ej1jjj1jjj for
 fiscal year #bjba2  7#e7 #ee1jjj1jjj   
for fiscal year #bjbb2  7#f7 #fj1jjj1jjj
 for fiscal year #bjbc2  7#g7           
#fe1jjj1jjj for fiscal year #bjbd2  7#h7
 #gj1jjj1jjj for fiscal year #bjbe2     
7#i7 #ge1jjj1jjj for fiscal year #bjbf2 
7#aj7 #hj1jjj1jjj for fiscal year #bjbg2
 and  7#aa7 for fiscal year #bjbh1 and  
each subsequent fiscal year1 the amount 
appropriated for the preceding fiscal   
year adjusted by the greater of the     
annual percentage increase in the       
medical care component of the consumer  
price index for all urban consumers     
7,u4,s4 city average7 as rounded up in  
an appropriate manner1 or the percentage
 increase for the fiscal year involved  
under section #ajejc7;b77#a77,p7 of the 

,patient ,protection and ,affordable    
,care ,act4  4  7b7 ,limitation ,amounts
 otherwise appropriated for ,nurse      
,practitioner ,residency ,training      
,programs may not be reduced as a result
 of the appropriations made under this  
section4  7c7 ,availability of funds    
,amounts appropriated under this section
 shall remain available until expended4