Photographer: Andrew Harrer/Bloomberg
Congressional Bickering Puts Billions at Risk for U.S. Health CentersBy
Clinics provide crucial access to medical care for poor people
A temporary fix for the federal program will expire in March
Lolita Lopez was forced to close one branch of the Delaware-based Westside Family Healthcare network she runs, and now she’s worried she’ll have to shut more unless Congress gets its act together.
Westside is among the roughly 1,400 community health centers in the U.S. that serve about 25 million people a year under a federal program that provides crucial medical care for poor people. The centers receive $5.1 billion in federal funding each year, but most of that money dried up on Sept. 30 and a highly polarized Congress appears to be in no rush to approve a long-term extension. A temporary fix ends in March.
The lack of permanent funding has affected the way centers handle critical issues, such as treating the opioid epidemic, and how they recruit and retain staff.
“We’re on day-to-day mode trying to keep our heads above water, let alone do anything strategically or innovative,” said Lopez, the chief executive officer of Westside, which handles more than 100,000 patient visits each year.
The fear at federally qualified health centers echoes the concern of state officials who faced similar cuts in the Children’s Health Insurance Program, which fell victim to partisan gamesmanship on Capitol Hill before a recent extension. While there’s been talk of extending the community health program in the next government funding bill, the centers are preparing for the worst.
Despite the uncertainty, facilities like the Joseph P. Addabbo Family Health Center in New York continue to provide medical services. By 9 a.m. on Wednesday, the waiting room at the main branch in the Far Rockaway section of Queens was bustling with visitors there to access everything from dental care to an on-site pharmacy.
“It alleviates the stress of traveling far to look for health support,” said Agatha Obasa, 37. “It’s very important.”
Of the $5.1 billion in funding, 70 percent comes from a community health center fund that was established under the 2010 Affordable Care Act. Community health centers have been able to preserve their current services under the short-term funding.
“We have lost some providers who say, ‘You know what? I love this community, I love working with Addabbo, but every day we read the paper Congress is silent on this 70 percent,” said CEO Marjorie Hill. “I am very worried that Congress will do nothing, that the president will do nothing, and that we will be faced with making -- I don’t want to overstate -- but catastrophic decisions.”
Two Democratic members of Congress, Representatives Rosa DeLauro of Connecticut and Lisa Blunt Rochester of Delaware, invited local leaders of community health centers to Tuesday’s State of the Union address by President Donald Trump to highlight the crisis.
“This issue has come below the radar screen, and I think that we have to have a very, very public discussion,” DeLauro said in an interview. “They meet a really crying need for people who have fallen on hard times.”
Dedicated federal funding accounts for about 20 percent of community health center budgets, according to Dan Hawkins, the senior vice president for public policy and research of the National Association of Community Health Centers. The rest comes mostly from Medicaid, Medicare, private insurance and grants.
Legislation is currently being considered to extend funding, and Hawkins said his organization expects that a fix will be attached to broader government appropriations by a Feb. 8 deadline.
Rochester is also hopeful about finding a solution soon. CHIP, which provides health coverage to poor children, was recently extended by Congress for six years. The lawmaker said she would be happy with an extension of similar duration, but she said she was concerned about the short time frame remaining to negotiate a deal.
Meanwhile, the quandary is proving stressful for health-center officials. Workers are leaving and budgets are being combed through in search of savings.
“The uncertainty is disabling in and of itself, let alone what’s coming down the pike,” said Suzanne Lagarde, CEO of Connecticut’s Fair Haven Community Health Care. “We are the safety net of this country and we deliver high-quality care in a cost-effective manner, and no one can dispute that. And they’re about to eviscerate us.”