Community Clinics Have Key Role In Health Reform

By: Associated Press Email
By: Associated Press Email

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Wednesday, October 14, 2009

As the recession grinds on, more and more people are relying on taxpayer-supported health centers that offer care on a sliding fee scale. If Congress passes a law giving more Americans access to health insurance, the clinics will also be a critical element to ramping up capacity to care for millions of new patients.

This year, federally qualified clinics are on track to handle more than 20 million patients — 2 million more than last year. Visits by uninsured patients jumped 21% from 2008 to 2009.

Legislators working to restructure the health care system are planning to nearly quadruple the clinics' federal funding. House Democrats would provide billions of dollars over the next decade, as would a version of the Senate health care bill.

But first, the clinics spread across 7,500 communities nationwide must cope with a historic surge in demand at a time when 27 states have cut their health care budgets.

Waiting lists at some centers have grown to hundreds of families, according to the National Association of Community Health Centers.

Unlike free clinics, which run mostly on private donations and city funding, federally qualified health care centers receive money from the federal and state governments to varying degrees. The fees paid by uninsured patients are important, but they only cover a fraction of costs, providers said.

House and Senate health care proposals would bolster the clinics' mission of caring for low-income and underserved communities, a mandate dating to President Lyndon Johnson's war on poverty.

The money would also prepare community clinics for the onslaught of new patients that would probably result from giving more Americans access to care — a national version of what happened in Massachusetts after the state required patients to be insured.

Wendi Niehuis, an information security analyst from Walnut Creek, lost her job with Washington Mutual in February. Eight months later, she has cashed in her retirement plan, but feels she is one serious illness away from financial ruin.

"I didn't think I'd ever be without health insurance," she said. "Now I don't know if I'll ever have it again."

Such patients are walking into centers in record numbers, said Dan Hawkins, Senior Vice President of Policy and Research for the National Association of Community Health Centers.

"Many of them had a good job, had insurance, were pretty solidly in the middle class, and the bottom just fell out," Hawkins said.

A one-time injection of $2 billion in stimulus money is helping cover the rise in demand. But much of that money was intended for capital expenditures such as building new clinics, not new patients.

At least 27 states slashed funding for health programs, with California leading the way. Gov. Arnold Schwarzenegger eliminated in July a $35 million pool of money designed to support centers serving rural areas, migrant agricultural workers and Native Americans.

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