Cuts to Community Health Centers Harm Communities of Color the Most
Cuts to Community Health Centers Harm Communities of Color the Most
Health Centers Provide Crucial Care to Underserved Populations
With funding at risk, the importance of community health centers in meeting the health care needs of the most disadvantaged and underserved can’t be overstated, write Julie Ajinkya and Gabby Bryant.
CHCs provide essential care to disadvantaged and underserved populations, particularly communities of color and low-income populations in urban and rural areas, and successfully reduce racial and ethnic health disparities in the broader population. The primary and preventive care CHCs provide saves the national health care system $24 billion annually, and the centers also create jobs and generate billions of dollars in economic activity.
As National Health Center Week comes to a close, and the newly appointed Super Committee of 12 members from both parties and both chambers is tasked with finding an additional $1.2 trillion in deficit reduction, the importance of continued funding for community health centers, or CHCs, must be underscored.
CHCs have already suffered a serious decrease in funding despite health centers’ benefits, as well as allocations from the Affordable Care Act to build upon their successful work in underserved communities. As we move forward with further deficit-reduction negotiations, CHC funding should be underlined as a smart investment that not only ensures all communities have access to efficient health care regardless of their race or ethnicity, but also as a strategy that saves money and creates jobs in this strained economic climate.
CHCs are a smart investment
Given the fact that CHCs generate enormous savings to the health care system and facilitate economic revitalization in under-resourced communities, funding reductions to the health center program are particularly counterproductive in this difficult economic climate. The total cost of care for CHC patients is 31 percent lower than care for individuals served by other providers, and last year alone, CHCs saved the health care system $24 billion by reducing the need for more expensive emergency room, hospital inpatient, and specialty care. Currently, CHCs serve more than 20 million people annually, but if they were allowed to expand their capacity to serve even 30 million people nationwide by 2015, these savings would double to $40 billion annually.
Health centers also serve as engines of economic activity, by providing economic development and job creation for the communities they serve. The National Association of Community Health Centers has shown, for instance, that every $1 million in federal funding for health center operations yields $1.73 million in jobs and economic activity. In 2009 health centers generated $20 billion in direct and indirect economic activities to resource-poor communities and produced 189,158 jobs in some of the country’s most economically challenged areas.
CHCs close the health gap
A national breakdown of CHC patients by race and ethnicity shows the importance of health centers in achieving the goal of expanding access to care for all Americans. CHCs were a crucial source of health care for more than 20 million people nationwide in 2010 but the centers disproportionately served members from disadvantaged and underserved groups such as communities of color and low-income populations. The Health Resources and Services Administration, or HRSA, for instance, reports that 25.8 percent of health center patients were African American and 34.4 percent were Hispanic in 2010 (compared to their respective 13 percent and 16 percent shares of the national population). And 71.8 percent of patients lived at or below the federal poverty guidelines.
Health center care is also quality care. CHCs have proven successful at reducing racial and ethnic health disparities because they are not only aware of these disparities but they make it their goal to correct for them. In many ways CHCs are ahead of larger health care providers by emphasizing the importance of cultural competency. By better understanding cultural differences, CHCs have more successful interactions with patients and can avoid the frustration both the patient and the health care provider experience when communication is difficult. Health centers’ boards are also governed by and for members of the communities served. This unique position in underserved communities leads to closing the health gaps between racial and ethnic groups that are illustrated in the accompanying infographic.
Studies show that the racial and ethnic disparities demonstrate the need for the consistent and considerate care CHCs can provide. Low birth weight, for instance, is lower among health center patients than their counterparts treated in other settings, despite the former population being at higher risk. As one of the primary causes of infant mortality, low birth weight is a primary concern for African American women who are at the highest risk for adverse pregnancy outcomes. Yet low birth weight is preventable among newborns with the early prenatal care that CHCs provide in communities of color. Health centers are better positioned to face these gaps in care that for too long have been ignored by other health care providers and have led to the devastating disparities we see today.
CHCs’ funding decrease
While CHCs are clearly helping communities of color and low-income populations access much needed care, the health center program’s funding is in danger. The Affordable Care Act specified the distribution of an additional $11 billion over the next five years that would allow CHCs to nearly double their current capacity to 40 million patients by 2015.
The FY 2011 discretionary funding reduction, however, cut the program’s funding by $600 million. And in this current budgetary climate, the outlook for this discretionary funding reduction being restored is not good. The $600 million cut would need to be backfilled each of the next five years using Health Center Fund money meant for the program’s expansion. Over five years, this would cut $3 billion, or almost 30 percent, out of the $9.5 billion in Affordable Care Act funds allocated for health center operations expansion.
These funding cuts have already affected the health center program. On Tuesday HRSA announced awards of $28.8 million from Affordable Care Act funds to establish 67 new CHC sites across the country. While these funds will provide an important source of quality health care for 286,000 patients, HRSA received 800 applications for funds and had been planning on funding 350 new sites prior to the cut.
The announcement also did not mention the 1,200 “Expanded Services” applications the department received from current sites seeking to offer improved services such as adding new providers and expanding hours. Though the HRSA could technically award funds for expanded services in a separate announcement, it is highly unlikely, given the cost of funding these applications and the fact that mathematically, with the FY 2011 funding reduction, there will not be funds available to provide for this assistance.
As the bipartisan Super Committee negotiates further cuts and deficit reduction, it should remember that the health center program has traditionally secured strong bipartisan support. In fact, this past spring Reps. Frank Pallone Jr. (D-NJ) and Gus Bilirakis (R-FL) circulated a sign-on letter in the House and Sens. Tom Harkin (D-IA) and Richard Shelby (R-AL) circulated a letter in the Senate indicating support for the health center program in FY 2012 appropriations.
While the congressmen applaud CHCs for the critical role they play in America’s health care safety net, it is clear that CHCs play a particularly important role in the health care of communities of color. Any more funding reductions would disproportionately hurt these communities and do nothing to close the important gap in racial and ethnic health disparities nationwide.
Julie Ajinkya is a Policy Analyst for Progress 2050 and Gabby Bryant is an intern for Progress 2050 at American Progress.
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