State Policy Updates

For updates on primary care-related actions by the administration and Congress, head to Federal Policy Updates.

For updates on efforts individual states are making to improve measurement and increase investment in primary care, visit the Primary Care Investment Efforts in States page

Legislative briefing on reorienting New York's health system toward primary care

"We know that health systems that are oriented toward primary care function better... having access to a primary care provider means you'll be focused on [wellness]... You are concerned with your health on an everyday basis, not just when something is hurting."

- New York State Senator Gustavo Rivera

This week, the Primary Care Development Corporation (PCDC), a PCC Executive Member, hosted a legislative briefing with legislative cosponsors Assemblyman Richard Gottfried and Sen. Gustavo Rivera as well as PCDC CEO Louise Cohen to discuss A7230-B (Gottfried)/S6534-C (Rivera), pending legislation in the New York State legislature that would initiate the first step in a transformational process to reorient New York's health system toward primary care.

This event also featured the important voices of two primary care clinicians who shared their perspectives on how clinicians make a difference in their communities, challenges they face, and how we can support them and their communities better by investing in primary care.



  • Assembly Member Richard N. Gottfried, Chair, Assembly Health Committee
  • Sen. Gustavo Rivera, Chair, Senate Health Committee
  • Louise Cohen, Chief Executive Officer, PCDC
  • Pascale Kersaint, MD, Chief Medical Officer, Brooklyn Plaza Medical Center, Inc.
  • John Rugge, MD, Founder, Hudson Headwaters Health Network


On the wellness curve, focus on primary health care will put California ahead

California led the nation in health care reform by enabling millions to obtain health insurance through the Affordable Care Act. This year, by expanding Medi-Cal to all Californians with low incomes, regardless of immigration status, our state will achieve another milestone: historically low numbers of residents lacking health insurance. 

Having an insurance card, unfortunately, doesn’t guarantee access to a primary care team that knows you, your family or your community. Absent such relationships, many get lost in or ignored by the system, or don’t trust it — as shown during the COVID-19 pandemic. California’s next challenge is to resolve the mismatch between coverage and quality care by making sure all of us have access to primary care.

To address this, Covered California and the California Public Employees’ Retirement System are working with other health care leaders statewide to strengthen primary care. 

Guest editorial: The critical need to invest in rural health care

The global pandemic has, rightfully so, grabbed headlines as we all grapple with its ongoing impacts on our health care system. What COVID-19 has also made painfully clear is how strained that system is, particularly in rural communities.

The fact that rural health care is underfunded and understaffed is a story we know all too well — one that started long before the pandemic. The lingering impacts from COVID-19 could have a ripple effect on the more than 1 million Washingtonians who live in rural areas and already face long-standing hardships when trying to receive care.

Michigan primary care doctors push for more state investment to address worsening shortage

People who regularly see primary care physicians tend to live longer and healthier lives – if they can locate and secure doctors near home, Michigan doctors said.

Despite the necessity of such practitioners, who handle patients from birth to death, from newborns to grandparents, there are too few of them and trends suggest there will be even fewer as current practitioners age and medical students with six-figure loan debts chose more lucrative specialties.

Nearly 3 million people live in parts of the state with an inadequate population-to-provider ratio, according to the Kaiser Family Foundation, which cited 2021 data from the U.S. Health Resources and Services Administration. The problems are especially stark in rural regions and urban centers.

Michigan facing shortage of primary care physicians, to get worse by 2030

Michigan is experiencing a decline in the number of primary care physicians, with more shortages expected by 2030, particularly impacting residents in underserved areas.

As primary care system nears 'breaking point,' Vermont lawmakers consider a rescue plan

If you’ve ever had trouble finding a primary care doctor, or getting an appointment with one when you’re sick, you’re not alone. And some of Vermont’s top medical experts say the primary care shortage is about to get worse.

As state Senate lawmakers consider provisions that would funnel more money into primary care services, doctors are raising some existential questions about the future of preventative care.

Primary Care Development Corp. Urges N.Y. Governor to Make Primary Care a Central Focus of Her Health Care Commitment

Primary Care Development Corporation (PCDC), a New York-based, national nonprofit organization and PCC Executive Member that aims to increase access to primary care and achieve health equity through strategic community investment, capacity building, and policy initiatives, was very pleased to hear N.Y. Gov. Hochul begin her State of the State address on Jan. 5 by clearly recognizing that “[t]he health of every New Yorker depends on a strong, stable, and equitable health care system, and health care workers are its very foundation.” PCDC wholeheartedly agrees and, as COVID-19 continues to surge into 2022, believes that New York State must move swiftly to strengthen and invest in primary care and the primary care workforce in order to achieve health equity and protect its communities throughout the pandemic era and beyond. PCDC applauds the governor’s commitment to investing $10 billion for health care, including for capital infrastructure and to grow the health care workforce by 20 percent over the next five years. PCDC urges all New York leaders to specifically center primary care in this historic investment.  

“Primary care saves lives, leads to better individual and community health, and is unequivocally central to health equity — yet we continue to undervalue and underfund it, which hurts marginalized communities most,” said PCDC CEO Louise Cohen. The COVID-19 pandemic has underscored and exacerbated existing health disparities. Communities of color and low-income, rural, and other historically disinvested communities had less access to primary care before the pandemic and have experienced both more COVID infections and greater COVID-related mortality and morbidity throughout the pandemic.  

There is an urgent need to re-orient New York’s healthcare system toward primary care, the only part of the health system that has been proven to lengthen lives and reduce inequities at the population level while also reducing costs over the long run. PCDC looks forward to working with New York leaders to move toward a primary care-centered health system, investing in the care that will address long-standing health disparities, improve the health status of underserved communities across New York State, make New York’s health system more effective during this pandemic, and help keep all New Yorkers protected in any future public health crisis. 

Safest States During COVID-19

As the U.S. continues its efforts to overcome the COVID-19 pandemic amid a surge in cases caused by variant strains, staying safe is one of Americans’ top concerns. Safety is also essential for getting the economy back on track, as the lower COVID-19 transmission and deaths are in a state, the fewer restrictions there will be and the more confidence people will have to shop in person. While almost all states have fully reopened, we’ll only be able to completely get back to life as normal once most of the population is fully vaccinated against coronavirus. The good news is that the U.S. is picking up speed with vaccination, as around 51% of the population has been fully vaccinated against COVID-19 as of August 18.

Some states are already safer than others, though, based on how well they have kept the pandemic under control and how much they are vaccinating. In order to find out the safest states during the COVID-19 pandemic, WalletHub compared the 50 states and the District of Columbia across five key metrics [primary care was not one of them, however]. Our data set includes the rates of COVID-19 transmission, positive testing, hospitalizations and death, as well as the share of the eligible population getting vaccinated.


Source: WalletHub

Source: WalletHub

Lessons Learned From Maine’s Nation-Leading Vaccination Efforts

Maine has been a leader in the nation over the past four months, from March through June 2021, in terms of the proportion of its population that has been fully vaccinated. This accomplishment is in spite of several major demographic and infrastructure challenges.

Delaware House passes bill that continues recent efforts to strengthen primary care system in the state

On June 29, the Delaware House passed a bill that continues recent efforts to strengthen the primary care system in the state by:

  1. Directing the Health Care Commission to monitor compliance with value-based care-delivery models and develop and monitor compliance with alternative payment methods that promote value-based care.
  2. Requiring rate-filings limit aggregate unit price growth for inpatient, outpatient, and other medical services to certain percentage increases over the next 4 years.
  3. Requiring an insurance carrier to spend a certain percentage of its total cost on primary care over the next 4 years.
  4. Requiring the Office of Value-Based Health Care Delivery to establish mandatory minimums for payment innovations, including alternative payment models, and evaluate annually whether primary care spending is increasing in compliance with the established mandatory minimums for payment innovations.

The senate passed the bill in May.

The legislation is modeled on Rhode Island's pathbreaking "affordability standards" that give the state insurance commissioner authority to promote investment in primary care through review of insurance plans' rates.

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