"Biden will more than triple the number of community health workers – often workers of color serving the communities where they live – who are part of a national effort to both prevent and treat chronic conditions in underserved, economically-disadvantaged urban and rural communities."
President Joe Biden directed funding to increase the community health worker force, but its numbers did not grow by 150,000 during his presidency.
Community health workers often labor in underserved communities, acting as liaisons between the people living there and health and social services. These workers may provide health education tailored to their community and help community members get medical or translation services.
As a 2020 presidential candidate, Biden promised to "more than triple" the number of community health workers in the U.S. as he pushed to expand the public health workforce.
It's difficult to determine the exact number of community health workers because their job titles vary and many are volunteers. But based on available job statistics, Biden's promise has not been fulfilled. The federal Bureau of Labor Statistics estimated that 58,670 people were employed as community health workers in May 2020. The number had increased by 8% in 2023 to an estimated 63,400.
The Bureau of Labor Statistics projected that number will grow by 13% through 2033, adding more than 8,000 new jobs.
Although Biden didn't increase the workforce by as much as he'd promised, the federal and state governments have invested in community health workers during his term. Biden's White House said in 2022 it had awarded $225 million from the American Rescue Plan to train 13,000 new community health workers.
The American Rescue Plan included $1.1 billion for community health, outreach and health education workers, and the Biden administration said the investment would yield more than 40,000 new jobs in community health in the long term.
The Health Resources and Services Administration, a division of the U.S. Department of Health and Human Services, announced a new three-year community health worker training program in 2022. The program recruited 2,416 new trainees and 432 existing community health workers during the 2022-23 academic year. Of the recruits, 1,098 completed their training that year.
The 2023 Consolidated Appropriations Act also included $50 million annually, through 2027, to train community health workers and build the workforce, health news nonprofit KFF reported.
Community health worker services are also being increasingly covered by Medicaid, which is federally funded and state-administered. Twenty-nine states reported allowing Medicaid payments for community health worker services in a 2022 KFF survey, and eight states reported adding or expanding coverage of their work in KFF's latest survey, from October 2024.
Several states have also directed funding to train and recruit community health workers during Biden's term. KFF said several states reported plans to introduce new certification programs and expand the number of community health workers in 2022. In 2023 and 2024, California devoted $280 million to recruiting and training 15,000 new community health workers by 2028.
Based on available jobs statistics, the number of community health workers grew during Biden's term because of targeted funding from Congress, the Biden administration and states, and is projected to grow in the next decade. But it did not grow as much as Biden promised. For that reason, we rate this promise Compromise.
As a presidential candidate, Joe Biden promised to expand the use of community health workers to prevent and treat chronic conditions in economically disadvantaged communities.
During his first year in office, several states have worked to increase the number of community health workers under Medicaid, the federal-state program that pays for health care for lower-income Americans.
Community health workers operate on the front lines, connecting individuals and families to health care resources in their local community. They include care coordinators, community health educators, outreach and enrollment agents, patient navigators and peer educators.
Community health workers often work to enroll lower-income Americans into Medicaid, a program that is handled somewhat differently in every state. Every year, the Kaiser Family Foundation surveys Medicaid budgets in all 50 states to track trends.
In the most recent survey, released in October 2021, Kaiser found that a number of states are working to expand the number and reach of community health workers.
Five states are adding community health workers as a Medicaid-covered service for fiscal year 2022: California, Illinois, Louisiana, Nevada and Wisconsin. California and Illinois are going further by establishing community health workers as a specific provider category under Medicaid, as are Arizona and the District of Columbia.
Meanwhile, Colorado and Oregon are incorporating community health workers into their redesign of case management coordination under Medicaid. Oregon also passed state legislation to recognize tribal traditional health workers as a type of community health worker.
It remains to be seen whether the total number of community health workers will rise by 150,000, as Biden promised. But states are leveraging the federally funded Medicaid program to expand the use and reach of community health workers. We rate this promise In the Works.