Another health funding cliff puts care for millions at risk

There’s another health deadline at the end of the month that has nothing to do with ObamaCare — but which puts millions of the nation’s most vulnerable patients at risk.   

Billions of federal dollars for community health centers, which provide care for some 26 million patients, is on the line with a Sept. 30 funding deadline looming. 

{mosads}The funding path is murky, with an agreement not yet reached and the House in session for only a week until the program expires. In the Senate, Republicans are examining a last-ditch effort to repeal ObamaCare, which could make time on the legislative calendar tricky. 

A lapse in funding could have huge implications. Community health centers are the largest source of comprehensive primary care for medically underserved populations, and they must take everyone who walks through the doors — regardless of if the patient can pay. 

A letter from more than 70 national groups to congressional leaders highlighted the stakes.

“According to [the Department of Health and Human Services’] own estimates, a failure to renew these funds would lead to loss of 51,000 jobs, closure of 2,800 [community health centers] delivery sites, and a loss of access to care for more than nine million patients,” the groups wrote earlier this month.

“To preserve the gains that have been made and strengthen our system of access to primary and preventive care, Congress must act expeditiously to avert this funding cliff.”

Funding community health centers is traditionally a bipartisan affair, though the two chambers appear to be taking different approaches.

The House is still wrestling to craft a package to fund other programs set to expire at the end of the month, such as the Children’s Health Insurance Program (CHIP).  

When the House returns next week, Energy and Commerce Committee Chairman Greg Walden (R-Ore.) is hoping to mark up a package that includes funding for CHIP, community health centers and other extenders. 

The panel had hoped to mark up legislation last week before the House took a weeklong break, but that didn’t happen. The biggest stumbling block appears to be how to pay for the programs’ renewal, according to a person familiar with the negotiations.

Community health centers are “very bipartisan, so I don’t know why we just don’t reauthorize them for a five-year term,” Rep. Gene Green (D-Texas), ranking Democrat on the panel’s Health Subcommittee, told The Hill. “That’s what I’ve been asking for for the last number of months.”

Last week, a bipartisan group of House lawmakers introduced legislation to extend funding for community health centers for five years with modest increases. 

On the other side of the Capitol, the Senate Finance Committee announced a bipartisan five-year deal to fund CHIP last week, and the bill text was released Monday. The measure doesn’t include funding for community health centers, which is in the Senate Health Committee’s jurisdiction.

Senate Finance Committee Chairman Orrin Hatch (R-Utah) has made it clear he doesn’t want any other programs added to his panel’s CHIP bill but is open to what leadership wants.

“I think CHIP ought to stand alone; I’d like to keep it that way,” Hatch told reporters Thursday.

Sen. Patty Murray (Wash.), the top Democrat on the health panel, said she’s “seen first-hand the critical roles community health centers play in helping patients get health care when and where they need it.”

“But unless Congress acts by September 30th to provide the investments and certainty these centers need, access to primary care and preventive health services for millions of people nationwide will be in jeopardy,” Murray said in a statement to The Hill.

Sens. Roy Blunt (R-Mo.) and Debbie Stabenow (D-Mich.) will send a letter Tuesday to Murray and Senate Health Committee Chairman Lamar Alexander (R-Tenn.) to show their “strong support” for community health centers and urge a “swift resolution to the funding cliff community health centers face at the end of the month.”

Including Blunt and Stabenow, 61 senators — both Republicans and Democrats — signed onto the letter.

ObamaCare created a special trust fund for community health centers, and this funding, a noncontroversial element of the law, is what’s at stake at the end of the month. About $7.2 billion in total funding was extended in 2015 for two years, packaged in with a broader doctor payment fix deal that also included money for CHIP.

More than 70 percent of federal grant funds for health centers is from this pool of money, and centers across the country are anxiously waiting to see if Congress will continue the funding.

The federal money “helps really keep the lights on, basically, in their primary care, women’s health, pediatric, dental, optometry and behavioral health services,” said Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County. 

For example, one clinic in the area would lose about $8.4 million in federal funding — 70 percent of their federal funding and 9 percent of their total budget.

“Folks are trying to do the math the best they can,” McCarthy said.

It’s been a year filled with uncertainties for community health centers with the funding cliff and the GOP’s efforts to repeal and replace ObamaCare, as health centers also see more patients who have health coverage because of ObamaCare’s Medicaid expansion.

This story has been corrected to note Rep. Green is the ranking member on the Health Subcommittee.