Health-Care Safety Net Hitting a Snag


While lawmakers’ attentions have been focused on Obamacare repeal, other health-care programs are now bumping up against thorny deadlines, leaving America’s safety-net providers feeling a little less secure.

Community health centers are set to see an Affordable Care Act-created fund—that covers 70 percent of their total grant dollars—expire this week.

These providers care for around 24 million vulnerable people who live in medically underserved areas, according to the Kaiser Family Foundation. Nearly half (47 percent) are insured by Medicaid and the Children's Health Insurance Program (CHIP).

And though the health centers wouldn’t see cuts until January, they’re starting to worry about how delayed congressional action could hurt their workforce—which already faces shortages. Without a guarantee of the federal resources, some are unsure how to navigate upcoming, multiyear contract deadlines to retain spaces and doctors, Dan Hawkins with the National Association of Community Health Centers told me.

“[Community health centers] may be nonprofit, but they’re businesses—small businesses—and as businesses they have to stay afloat,” Hawkins, the group’s senior vice president for public policy and research, said Monday. “In order to do that they have to know, or have a good feel at least, where they stand revenue-wise going forward. That’s the crux of the dilemma.”

A bipartisan House bill that would extend the fund for five years is gaining support, Hawkins told me, with around 80 co-sponsors. On Tuesday, another lawmaker—Republican Rep. Randy Hultgren of Illinois—threw his name onto the Community Health Investment, Modernization and Excellence (CHIME) Act of 2017.

And the safety-net centers believe they’ll have their funding protected, likely for two years. Hawkins added, though, that Congress is struggling to find the right cost offsets.

Meanwhile, without action, they face worrying numbers and possible disruptive effects. Around 2,800 could close—and leave 9 million patients without health-care access.

That number echoes another program facing a looming Sept. 30 deadline: CHIP, which covers nearly 9 million kids whose families make too much to qualify for Medicaid but not enough to secure private health coverage. A CHIP reauthorization bill for five years was introduced in the Senate, but House lawmakers said this week they had yet to strike a deal.

“If those folks were to lose that coverage, the health centers would still have at least the moral obligation if not legal obligation to provide care for those individuals, but without resources and [they would] not be able to afford staff and other costs related to providing care,” Hawkins told me.

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