Neighborhood health clinics popular with veterans face crisis as federal funding evaporates

Kymberly Grafton winces with every step she takes, the lingering burden from a training accident and car crash. And the disabled Navy reservist’s pain may soon be compounded by a budget battle on Capitol Hill that threatens her neighborhood health center.

Grafton is one of 300,000 low-income veterans who receive health care at community health centers nationwide.

She gets regular treatment at Unity Health Center near her home in Washington’s Anacostia neighborhood, allowing her to skip a miles-long trek to the nearest hospital.

“It’s very important because of my disability. Because I cannot walk, stand for long periods of time. This works for me because it’s close to my home,” Grafton said.

The Affordable Care Act, also known as ObamaCare, established the Community Health Center Fund to provide money for the operation, expansion and construction of community health centers to improve access for low-income Americans and veterans who live far from a VA hospital.

The National Association of Community Health Centers estimates that without new money from Congress, centers will face an immediate 70 percent cut in funding, resulting in 9 million patients losing care and 2,800 of an estimated 10,400 delivery sites closing.

“Where am I going to go?” Grafton asked, her eyes welling with tears. “Because of everything I have been dealing with from losing family members, being in a car accident, not being able to work, literally not having any money to my name and being on public assistance, I’ve come to rely on this place a great deal. Especially for mental health services.”

Funding for community health centers expired at the end of September along with money for a children’s health program. The bill reopening the government signed by President Trump on Monday included a six-year extension of funding for the children’s health program known as CHIP, but did not include money for the community centers.

It’s possible funding for the health centers could be added to a new government-spending measure ahead of Feb. 8, the next shutdown deadline, but that’s also far from clear 

The problem could be acute for veterans because of a 2014 law that allows eligible veterans to receive care outside of VA providers, including at community health centers. The centers have offered veterans a broad range of services. In 2015, 78 percent of health centers offered veterans dental care and 83 percent offered mental health services.

“The consequences are huge,” said Leighton Ku, a professor with the Milken Institute School of Public Health at George Washington University who has studied the effects of community health centers on the areas they serve.

“There are about 10 thousand clinics across the country. They serve 27 million patients, some of the neediest patients in the country. If this money is lost, this $3.6 billion doesn’t get funded at all, which is still a possible outcome because Congress hasn’t taken action, as many as 9 million patients might lose health care,” Ku said.

Sen. Debbie Stabenow (D-Mich.) believes the funding failure in Congress is unconscionable.

“There’s no excuse for this,” Stabenow said in November, adding that veterans and children depending on the centers “shouldn’t be standing at the back of any line, nor should they be worrying about losing health care through the community health centers.”

Rep. Tom Cole (R-Okla.) said there is a bipartisan commitment in Congress to get funding passed and offered hope for a solution.

“Look, in the last few years … I certainly didn’t support ObamaCare but I think one of the good provisions was the expansion of the community health centers,” Cole said. “I think they’re a wonderful model. They’re a much cheaper way to deliver care to people that really need it. So, again, I think there is a commitment there to find a solution.”

Without a clear outcome, however, community health centers already are starting to evaluate possible cuts to staff and services.

“Our biggest concern if funding is not renewed is that we would have to really consider reducing our program size,” said Angelica Journagin, vice president for planning and external affairs at Unity Health Care. She said some health centers or services might have to be shut down.

The loss of health centers will impact more than care because they have also become a part of the local economy, Ku said.

“Part of what we point out in the analysis we did [is] it’s not just that patients lose health care, but we’re talking about maybe something on the order of 100,000 more jobs get lost across the country. States’ economies become weaker because of this,” the professor said.