Bay Citizen – “Federal Debt Deal May Pinch Community Clinics"
Health centers are bracing for an influx of low-income patients as health reform kicks in
The debt-reduction fight in Washington may shrink federal funding for community clinics at a time when the government is asking them to gear up for an influx of patients, local health officials said Monday.
The Obama administration is counting on community health centers, which currently care for one in six of the nation’s uninsured, to play a key role as federal health care reform extends coverage to some 32 million Americans by 2014.
“All of this expanded coverage would be completely meaningless if there is nowhere for people go to receive their care,” said Melanie Rhinehart Van Tassell, chief of staff for Rep. Mike Thompson, a Democrat whose district extends into Sonoma County. She was speaking before an audience of more than 130 local health care professionals, elected officials and community members at a Monday morning health care town hall meeting held at Sonoma County Indian Health Project in Santa Rosa.
Community clinics provide primary care to low-income populations. In California, some 800 community clinics and health centers already serve 4.7 million patients, according to the California Primary Care Association. In Sonoma County, about 110,000 people — approximately a quarter of the population — turn to the clinics for their health care, according to the Redwood Community Health Coalition.
High unemployment has increased demand for the services.
Since 2005, clinics in Sonoma have added capacity for 35,000 patients, according to the health coalition. They have plans to serve an additional 45,000 patients who will be insured by 2014 due to federal health care reform.
The reform bill includes an expansion of Medi-Cal, California's version of Medicaid, the federal safety-net program that covers many clinics’ lowest-income patients. That growth would extend coverage to many of the clinics' current uninsured patients and bring in new patients.
Some 20 percent of the Indian Health Project's 4,800 patients currently have no insurance, CEO Molin Malicay said. Once health care reform goes into effect, Malicay said he hopes all of those patients will be covered under Medi-Cal.
The health centers plan to provide a "medical home," emphasizing prevention. "We have a disease care system rather than a healthcare system," said Dr. Jason Cunningham, medical director of West County Health Centers in Sonoma County. With reform coming, "this is one of the most exciting times to be in primary care," he said.
But those plans may be in jeopardy as the federal debt-reduction plan plays out in Washington in next few months.
Medicaid escaped the hatchet in last week's federal debt deal. But $7 billion in cuts that have yet to be identified could include slashes to funding for community clinics.
And a 12-member Congressional “super committee,” now being formed, will be charged with coming up with at least $1.2 trillion in additional cuts, which could make Medicaid and funding for the community clinics vulnerable. Leaders must appoint members to the committee by Aug. 16, and it must vote on a plan by Nov. 23. The nation currently faces more than $14.3 trillion in debt.
Health centers have already seen some of the federal dollars they expected to help them prepare for health care reform dry up.
A pot of money available to help clinics open new locations shrunk to $40 million from $250 million in April, The Bay Citizen reported. Some $300 million for hiring new clinicians and increasing hours shrank to zero.
“If you do not take the time now to be an advocate, those who oppose the great progress we have made could win the day," Carmela Castellano-Garcia, CEO California Primary Care Association, told the audience in Santa Rosa.
Advocates contend that funding preventive care will save money in the long term.
“Community health centers are far cheaper than the alternative — which is waiting until people are so sick that they end up in the emergency room,” Alvaro Fuentes, executive director of the Community Clinic Consortium of Contra Costa and Solano counties, said in a statement.