Community Health Centers Face Cutbacks

By a News Reporter-Staff News Editor at Insurance Weekly News -- WASHINGTON, DC and NEW YORK ()--Repeal of key provisions of the Affordable Care Act, combined with a failure to renew critical funding streams, would result in catastrophic funding losses for community health centers-forcing these safety net providers to cut back on services, lay off staff or shut down clinical sites, according to a report published. The report represents the first analysis of the potential effects on medically underserved communities of the types of health insurance losses contained in legislation now pending in Congress.

The Congressional Budget Office has projected that the American Health Care Act as introduced on March 6th would eliminate health insurance coverage for 24 million people by 2026. At risk are ACA expansions of private insurance subsidies, and cuts to the Medicaid program, which is a key source of insurance coverage for health center patients, providing coverage to just under half of those served by community health centers in 2015. Reductions of the magnitude forecast by CBO could trigger deep reductions in health center services, according to the report from investigators at the Geiger Gibson/RCHN Community Health Research Collaborative at the George Washington University's Milken Institute School of Public Health (Milken Institute SPH).

"Impact estimates of rolling back the Affordable Care Act's insurance reforms have emphasized its implications for insurance coverage. We believe that this is the first study to gauge the possible effects of major reductions in coverage on primary health care access in medically underserved urban and rural communities," said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH and lead author of the report. "Close to half of all community health centers predict what can only be described as catastrophic financial losses that in turn would trigger a nationwide reduction in services."

To find out how reversal of the coverage gains and increased funding made possible by the ACA might affect community health center revenue, staffing, and patients, Rosenbaum and her colleagues surveyed community health centers between January and February 2017. The survey, which captured information from a representative group of nearly 600 centers in all 50 states, the District of Columbia and three U.S. territories, shows:

In 2015, community health centers served nearly one in 13 Americans. The findings from this study suggest that the rollback of insurance coverage carries enormous consequences for the accessibility of primary care in communities already at greatest risk for lack of care. These projected declines would, in turn, put a growing strain on hospital emergency care, just as hospitals are feeling the stress of major declines in insurance coverage, according to the report.

"Rolling back the gains made by the ACA jeopardizes both community health centers and the people they serve," said RCHN Community Health Foundation President and CEO Feygele Jacobs, whose organization funded the report. "It compromises services to the nation's most vulnerable communities and jeopardizes the very fabric of our health care safety net."

The report, "How Could Repealing Key Provisions of the Affordable Care Act Affect Community Health Centers and their Patients?" can be accessed here.

Keywords for this news article include: Legal Issues, Community Health, Health Insurance, Affordable Care Act, George Washington University Milken Institute School of Public Health.

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