Dr @hakeemjeffries here is what I would explore and test as an alternative to reinstating the PTC 1. Allow those who lost PTC, as a starting point for this test, to go to any FQHC or look alike, for $0. Support the facility with funding for more doctors/nurses and extended hours to cover the cost of more patients and zero direct revenue from them based on a formula and reporting 2. All FQHCS are eligible for 340b pricing. Fund 340b inventory for them, starting w those w their own pharmacy , with a line of credit at wholesalers , while requiring them to bill CMS or Treasury (legislation would be needed here ) their cost plus 10 pct for associated overhead. There would be $0 OOP to patient. To get a prescription, the patient must be an ongoing patient of a doctor at the FQHC. YOU CANT JUST ASK FOR A PRESCRIPTION. The relationship must be ongoing. This prevents people from just using them for free meds. 3. FQHCS and look alikes are limited in the types of care they can offer. I would look closely at expanding their offerings. I would also look at expanding what communities they can be part of. 4. The FQHC would continue to offer the same pricing and services to non PTC eligible patients 4. For those who don’t know, FQHCS are non profit. More importantly, they are required to have 51 % of their board of directors be actual patients of the facility. They don’t have a profit motive. As best I have seen, their interests align with patients from a care and cost perspective. This isn’t perfect. But it’s far better than giving the big insurance companies free profits and allowing them to play doctor and deny care. https://www.ruralhealthinfo.org/topics/federally-qualified-health-centers All thoughts are welcome. See my next tweet on what can be considered for care that goes beyond what FQHCs can offer