Delaware Debates Primary Care Overhaul Amid Cost and Access Concerns

Doctors call proposed changes a lifeline, while hospitals warn of job losses and reduced care access.

Apr. 7, 2026 at 8:35am

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A translucent, ghostly X-ray image of a stethoscope against a dark background, symbolizing the complex issues surrounding primary care in Delaware.An X-ray view of a stethoscope illuminates the intricate challenges facing Delaware's primary care system as lawmakers debate reforms.Wilmington Today

Delaware lawmakers are considering major primary care reforms that would increase funding and oversight of value-based care models. Independent providers argue the changes would stabilize small practices, while hospital systems warn the bill could lead to job losses and limit access to care. The debate centers on how to improve preventive and affordable primary care in the state.

Why it matters

The proposed legislation aims to address longstanding financial challenges in Delaware's primary care system, which has seen independent practices struggle to stay afloat due to low insurance reimbursements. Supporters say the changes would strengthen preventive and value-based care, while opponents fear the bill could disrupt progress made in recent years and lead to service cuts.

The details

Senate Bill 1 would reshape how primary care is funded and regulated in Delaware. Key provisions include increasing the share of total medical spending that insurers devote to primary care, expanding oversight of value-based care models, and capping certain hospital reimbursement rates tied to Medicare. Proponents argue this would allow independent practices to focus on keeping patients healthy rather than maximizing patient volume, while opponents warn the bill could cost jobs and limit access to care.

  • In 2018, Delaware passed legislation requiring certain insurers to reimburse primary care providers at Medicare rates.
  • In 2022, a follow-up law further boosted primary care funding in the state.
  • Senate Bill 1 was introduced in the Delaware legislature in March 2026 and is currently under review by the Senate Finance Committee.

The players

Dr. David Donohue

Founder of Progressive Health of Delaware, a primary care practice that struggled financially due to low insurance reimbursements before the state passed legislation to increase funding in 2018 and 2022.

Senate Majority Leader Bryan Townsend

Sponsor of Senate Bill 1, which aims to further reform Delaware's primary care system.

Dr. Sarah Mullins

Physician at Stoney Batter Family Medicine, who argues that value-based care models allow independent practices to focus on preventive care and keeping patients healthy at a lower cost.

Brian Frazee

President and CEO of the Delaware Healthcare Association, which opposes certain provisions of Senate Bill 1 that could lead to job losses and limit access to care.

Dr. Sangita Modi

Physician at Advocare Newark Pediatrics, who says fair reimbursement is essential for caring for Medicaid patients and warns that more practices may be forced to close or turn away these patients without it.

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What they’re saying

“We were pretty much starved of cash. So we were able to survive, but we weren't really thriving.”

— Dr. David Donohue, Founder, Progressive Health of Delaware

“This system is not working. We have to steer it in a direction of wellness and more reasonable prices.”

— Senate Majority Leader Bryan Townsend

“I just simply want to prevent that stroke – and that is the end game for me.”

— Dr. Sarah Mullins, Physician, Stoney Batter Family Medicine

“These are the patients that really need the care.”

— Dr. Sangita Modi, Physician, Advocare Newark Pediatrics

“Simply kicking the can down the road for another two years is not going to get better quality for primary care patients.”

— Dr. Sarah Mullins, Physician, Stoney Batter Family Medicine

What’s next

The bill has been assigned to the Senate Finance Committee for additional review due to its fiscal impact. It will most likely be heard when lawmakers return to Dover after spring recess, which ends on April 14.

The takeaway

This debate over primary care reforms in Delaware highlights the broader challenges facing the U.S. healthcare system, as policymakers and providers grapple with how to improve access, affordability, and quality of care. The outcome of this legislation could have significant implications for the future of primary care in the state.