By Alexandra Sange
The public option, the exchange, the mandates – health care reform discussions have kept a tight focus on the (new) things Congress would create in various health reform bills. In today’s Nugget we’ll focus instead on an element of reform that builds on a program we know and love, and one of critical importance to Health Centers and our patients: Medicaid.
Medicaid patients make up about 1/3 of all health center patients nationwide and the Health Centers and Medicaid programs have a time-honored partnership. Health centers are located in low-income communities, where many other providers will not practice; they ensure that every patient has a health care home, a team of providers coordinating their care, and access to a full spectrum of enabling services from low-cost pharmacy to language assistance. Medicaid recognizes the unique and complex health care needs of millions of Americans; the Medicaid program reimburses health centers’ adequately and predictably for the full scope of services low-income individuals need. Together, Medicaid and Health Centers save money to the overall health care system and improve health outcomes for patients and communities.
This is what makes the Medicaid expansions coming down the pike in health care reform so important for Community Health Centers. Sara Rosenbaum, JD, Chair of George Washington University’s Health Policy Department, wrote a great article recently analyzing the impact of key changes to Medicaid in health reform; Kaiser Family Foundation has a wonky chart with the rest of the policy tweaks and expansions. For health centers, though, the most important change will be the expansion to Medicaid eligibility. Both the House and Senate would expand Medicaid eligibility considerably, extending benefits to all legal US residents under 133% of the Federal Poverty Level. This will open the program to another nearly 10 million patients – many of whom are currently uninsured, very low income, and managing complex health conditions – which, for the federal government, is a cost-saving proposition. Health centers return about 40 cents on the dollar for every Medicaid patient they treat, so as Congress struggles to keep a reform bill below the $900 billion mark, every penny saved is a penny earned. Health centers will continue to serve low-income communities, families and individuals. As Medicaid is expanded, health centers will see more patients with a regular payer source for comprehensive coverage, and will be able to collect reimbursement for previously uninsured health center patients.
NACHC and other advocates continue to work to ensure that Medicaid is expanded, protected and strengthened in reform, and the Partnership for Medicaid recently sent a letter to leadership in Congress stressing our vital role in protecting the health of low income Americans. Fortunately, the message is getting through to Congress: House Energy and Commerce Committee Chair Henry Waxman (D-CA) and others now cite health centers’ presence in low income neighborhoods and FQHCs’ comprehensive spectrum of services among Medicaid’s greatest strengths. But for health centers and their patients, this is more than a message – this is health care.