HR-10274-119
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Sponsored by Josh Harder (D-CA)
What it does
This bill would direct HHS and USDA to create a grant program for partnerships of clinics, hospitals, food banks, and community organizations to provide combined health and nutrition services—such as care coordination, "Food is Medicine" programs, and chronic disease education—to low-income and underserved communities. It authorizes $15 million per year from fiscal years 2027 through 2031, with grants lasting up to three years (renewable for two more), and requires recipients to report on health, access, and utilization outcomes.
Who benefits
Low-income individuals and families with chronic diseases (income at or below 200% of the poverty line) living in rural areas, health professional shortage areas, medically underserved communities, or areas of persistent poverty; community health centers, nonprofit hospitals, food banks, and nonprofit organizations that would receive grant funding and expand services; community health workers and patient navigators who could gain employment through funded programs.
Who is hurt
Applicants and communities that do not meet priority criteria (e.g., non-rural, non-poverty-designated areas) and thus compete for limited funds; taxpayers funding the $75 million total authorization over five years; entities lacking existing coalition agreements or grant management capacity, who may be unable to compete for awards; organizations providing similar services outside the grant structure that could face competitive disadvantage.
Supporters argue
Supporters argue that chronic diseases like diabetes and hypertension are closely linked to food insecurity, and that coordinating clinical care with nutrition support through structured "Food is Medicine" programs can reduce emergency department visits and hospitalizations, citing existing pilot studies showing improved health outcomes when medical and nutrition services are integrated. They contend targeting funds to rural, high-poverty, and medically underserved areas addresses documented gaps in access to both healthy food and primary care.
Opponents argue
Opponents argue that $15 million annually is a modest sum relative to the scale of chronic disease and food insecurity nationwide, potentially funding only a small number of pilot-scale programs with limited measurable impact. They contend that the administrative burden of forming multi-partner coalitions, meeting reporting requirements, and maintaining formal agreements for years may favor larger, well-resourced organizations over smaller community groups that could best serve the target populations.
Constitutional context
Congress is exercising its Spending Clause authority (Article I, Section 8, Clause 1) to fund a voluntary discretionary grant program; because participation and funding conditions are optional rather than coercive, this raises no significant constitutional question comparable to the Medicaid expansion coercion concerns addressed in NFIB v. Sebelius (2012).
Checks and balances
Congress authorizes the funding and sets eligibility criteria in statute, while HHS and USDA retain discretion over grant awards and program administration, with oversight through required reporting and appropriations review.
Historical precedent
Similar targeted federal grant programs combining health and nutrition services, such as the Health Center Program under Section 330 of the Public Health Service Act and various USDA nutrition assistance demonstration projects, provide a general precedent for this funding model.