Community health centers that provide critical primary care to 385,000 of Louisiana's poorest residents sounded alarm bells Tuesday about the possibility of deep cuts to their services if the federal government fails to reauthorize one of their key funding pools.
Louisiana, often falling at the bottom of national health lists, relies on more than 250 federally qualified health centers across the state to treat low-income people for their day-to-day needs.
But the national community health center fund that helps pay for almost 10,000 centers across the country expired Sept. 30, though lawmakers have kept the grant program limping along with temporary patches. Community health centers have struggled since then to plan for staffing needs, capital projects and more as they await confirmation on whether they will be able to keep operating. The fund provides $90 million annually to Louisiana's community health centers.
Congressional negotiators are working on a larger budget deal, which is expected to include financing for the centers. The U.S. House of Representatives passed a package of bills Tuesday evening that includes funding over two years for federally qualified health centers alongside a range of other items designed to avoid another government shutdown.
Final passage, though, will likely remain on hold for at least another day. U.S. Senate Democrats, at least nine of whose votes are needed to pass any funding deal, are expected to block the package because it doesn't boost funding for domestic programs alongside a hefty hike in money for the military.
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Funding for community health centers has previously received bipartisan support. Congressional Republicans and Democrats have recently pointed fingers at each other over who's to blame for the problems reauthorizing funding for the health centers.
But Louisiana community health center representatives said Tuesday that they are frustrated with political games overshadowing the need for safety net health centers that treat people regardless of their ability to pay.
"If there were no community health centers, there would be thousands of individuals who may have preventable diseases who might die prematurely," said Shondra Williams, the president of the Louisiana Primary Care Association and the chief executive officer of Jefferson Community Healthcare Centers.
Gov. John Bel Edwards joined Williams and other community health center leaders at a news conference at Southeast Community Health Systems in Zachary about the importance of their funding. The Louisiana Primary Care Association has lobbied the state's congressional delegation to approve funding for health centers.
Timothy Young, the chief executive officer of the Open Health Care Clinic in Baton Rouge, said in an interview that the $650,000 his clinic receives through the federal program is set to expire at the end of May. Though losing that money would not force Open Health to close, Young said it would force them to make choices about how many uninsured patients they can serve and whether they will have to slow down on expanding services.
About half the people who go to Open Health are on Medicaid or are uninsured, Young said. The clinic has recently seen an increase in the number of uninsured legal Latino patients as well as uninsured people who work in industries without benefits, including service industry workers, he said.
Mark Keiser, the chief executive officer of Access Health Louisiana, said funding community health centers saves governments money in the long run. Access Health runs more than 25 clinics across the state, with centers in New Orleans, Covington, Kenner, Bogalusa and elsewhere.
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Primary care treatment is important because it can catch diseases before they progress to become more difficult and more expensive to treat, he said. New Orleans has been especially successful post-Hurricane Katrina in routing people to community health centers. Previously, most of those patients used the emergency room at the former Charity Hospital, as well as various hospital-run clinics, for routine illnesses.
But Keiser said that progress would be put at risk without community health center funding, and that cuts to community health centers would add stress to hospitals and emergency rooms.
He said the federal funds make up 15 percent to 17 percent of "the money that's required to pay the bills" on any given year at Access Health, though nationally, the health center fund makes up 70 percent of funding for community health centers. And if Access Health were to take a cut, Keiser said their most widely provided service — primary care — would hurt the most.
Louisiana's federally qualified health centers were also on the front lines of enrolling people in Medicaid expansion, according to Louisiana Primary Care Association marketing and communications manager Ryan Sinitiere. Sinitiere said the extra funding from Medicaid expansion in Louisiana is not enough for clinics to make up for their possible losses of federal funding.
He also said community health centers are important economic drivers, and that a center in Winnfield, for example, is a top-five employer there.
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“There really isn’t opposition to funding these health centers around the country," the governor said. "That is really sad and is tragic, but it is where we are today in Washington.”
Sens. Bill Cassidy and John Kennedy, both Louisiana Republicans, signed onto a bipartisan letter Tuesday that urged Senate leadership to reauthorize community health center funding. U.S. House Rep. Ralph Abraham, a physician and also a Republican, also called community health centers a "critical safety net" and blamed Democrats for not authorizing their funding. Democrats, in turn, have accused Republicans of politicizing critical and bipartisan programs by insisting on including partisan provisions in the bills.
"These centers provide comprehensive medical services without courting controversy like Planned Parenthood does," Kennedy said in a statement. "Community health centers are vital to Louisiana families."
Ty Bofferding, a spokesman for Cassidy, blamed "Washington Democrats" for voting against health center funding. He said they will have "another chance to do the right thing this week."
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The political back-and-forth over health center funding mirrors the months-long battle over reauthorizing the federal Children's Health Insurance Program, or CHIP. Like the grants for federally qualified health centers, CHIP enjoys broad bipartisan support on Capitol Hill and is wildly popular among voters. Yet partisan squabbling in Congress contributed to both programs lapsing at the end of September and created roadblocks to a deal.
House Republicans in the fall passed a bill to reauthorize both CHIP and health-center funding — but paid for each by raiding Affordable Care Act funds earmarked for public-health programs and clipping Medicaid coverage for some high-earning seniors. Democrats objected to those "pay-fors," which left the bill dead on arrival in the Senate.
A six-year extension of the CHIP program was approved as part of the deal that ended January's government shutdown. But health-center funding wasn't included, something that New Orleans Congressman Cedric Richmond, the lone Louisiana Democrat in Washington, cited in voting against the package.