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Introduction
Community health centers are a crucial source of health care for a diverse group of patients, providing preventive services, treatment, and care management for medically underserved communities. That’s why these centers have enjoyed solid bipartisan support over the past several decades.
Today, though, the patient load in community health centers around the nation is on the rise. The number of people without access to affordable health care—60 million, or one-fifth of Americans, according to the National Association of Community Health Centers—is growing because of rising health care costs for individuals and families and due to persistent unemployment at near-double-digit percentages, which eliminates employer-based health insurance for those workers who lose their jobs and for their families, too.
This is why community health centers need more resources to deliver the best care to more patients. The new health reform law recognizes the important role of community health centers and provides significant new funding for the expansion and creation of new clinics. This issue brief presents the reasons why this funding must be preserved as Congress and the Obama administration grapple with efforts to trim our federal budget deficit over the next 10 years.
A history of bipartisan support
In a 2009 speech President Barack Obama stated, “health care isn’t just about diagnosing patients and treating illness—it’s about caring for people and promoting wellness. It’s about emphasizing education and prevention, and helping people lead healthier lives so they don’t get sick in the first place.” Former President George W. Bush also voiced his support of community health centers, stating that community health centers are “an integral part of the health care system because they provide care for the low-income, for the newly arrived, and they take the pressure off of our hospital emergency rooms.”
Indeed, throughout their recent history, government leaders from across the political spectrum have worked to improve the availability and quality of community health centers. In 2001 President Bush signed into law legislation to increase the number of community health centers and their patient loads, creating or expanding 1,200 clinics. Following this legislation, the Department of Health and Human Services continued to recommend increased funding for community health centers to support the increasing patient load.
The National Association of Community Health Centers strongly agrees. In 2010 NACHC said that the patient load of community health centers had risen to 20 million patients who were cared for at 7,900 community health center sites around the nation. Alas, NACHC estimated that in 2009 there were 60 million “medically disenfranchised” individuals in the United States, meaning that one-fifth of the population goes without ready access to primary care. Community health centers alleviate the burden placed on these patients and hospitals by providing these individuals with effective care.
Improving access to care and closing the disparity gap
Community health centers provide behavioral, mental, and primary care services. This comprehensive set of services helps people stay healthy, manages their health care problems, and reduces costly visits to the hospital. Community health centers are often the sole source of primary care for the populations they serve.
This population today includes a diverse array of low-income workers and their families, most of them ethnic or racial minorities, as well as individuals with disabilities, immigrants, and part of the gay and transgender community—all underserved communities prone to receiving disparate health care services. The accompanying map shows that more than half of the patients seen are ethnic or racial minorities. Most of these individuals are working people or children. These patients are more likely to be a part of the 50 million uninsured Americans because they tend to work low-wage jobs for which employers do not provide health care coverage. Additionally, long working hours, language barriers, and a lack of transportation often prohibit many individuals from regularly accessing care.
Cost benefits of community health care services
Above all, community health centers’ focus on prevention and helping stem the progression of chronic diseases—keeping individuals out of hospitals—will save our nation $17.6 billion per year—costs attributed to hospital visits. Specifically, these centers currently save $1,262 per person and will continue to cut patient costs by $1,520 per person by 2015.
Chronic diseases such as asthma, high blood pressure, and diabetes reduce annual productivity by between $200 and $440 per person. Minorities account for a large percent- age of those with chronic diseases. For instance, Hispanics and African Americans have a much higher rate of developing diabetes, hypertension, and heart disease than any other ethnic or racial group.
Dr. Augustus White of Harvard Medical School laid out at the Diversity Summit at the 2011 Bio Conference the financial consequences for the patients themselves, stating “if these laborers and minority members do not get culturally competent and adequate care, they will not be able to work, create an income, and provide for their families.” Families forgo expensive emergency room costs and are able to pay an inexpensive co-pay when receiving care from a community health center.
Affordable Care Act funding for community health centers
The Affordable Care Act continues this support and expansion for community health centers. Over the next five years, the health reform law will provide $11 billion for funding, expansion, and construction of community health centers across the country. Most of this money will go specifically to medically underserved areas, making health care more available to the people who need it most.
Community health centers will be able to build upon their history of strong primary care and mental, pharmacy, and dental services. In addition, community health centers will provide fundamental preventive care services, which pave the way for long-term health security. The Office of the Surgeon General says prevention is essential to keep Americans healthy, and thus lower health care costs. According to the OSG, “with better health, adults are more productive and at work for more days.”
The many faces of community health centers
The quality care at less cost that community health centers provide to low-income workers from diverse backgrounds through the Affordable Care Act is only one aspect of the new law. Funding and expanding community health centers will benefit many others in the communities they serve, among them:
• Health care professionals and employees. The expansion and creation of new community health centers will provide jobs for health care professionals and increase income for businesses delivering goods and services to community health centers. An increased income will also allow these businesses to hire more employees.
• Children. The Department of Health and Human Services reports that nearly one- third of patients who do not have health insurance are children, but many of these kids will have more access to medical professionals and health care sites with the expansion and financing of community health centers.
• Gay and transgender community. Community health centers will address health dis- parities by offering “high-quality, culturally competent care to medically underserved gay and transgender people.” These men and women include low-income lesbian, gay, bisexual, and transgender individuals and those with disabilities.
Conclusion
The new health law takes important steps to help alleviate the gap in health disparities among different racial and ethnic groups, and enhances protections for consumers, which is—as the accompanying map shows—particularly important for many low- income people of color. The ultimate goal must be that all Americans, regardless of race, ethnicity, or any other factors, get the quality health care services they need when they need them. We can ill afford to ignore the high cost in dollars and human life that the nation pays each year that is attributed to health care disparities, especially when much of the burden from chronic illnesses is preventable.
Community health centers help reduce health care disparities and promote a healthier America, and are able to help even more people through the new health reform law.
Shivani Parikh is the Health Policy Intern at the Center for American Progress.
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