2017 brought forth a year of challenges for Community Health Centers that included natural disasters and a man-made one: a funding cliff. The funding cliff came as it was revealed that health centers now serve more people than ever at 27 million, or 1 in 12 Americans. Leading up to the funding cliff deadline was uncertainty across the nation about the future of insurance coverage while Congress made multiple attempts to repeal the Affordable Care Act.
As we face growing uncertainty around the future of our health care system, it is even more critical that we strengthen and expand these health centers… their unique mission and success in keeping health care costs down are why proposals to put health enters in more communities have garnered considerable bipartisan support.” — Former Senate Majority Leader Tom Daschle and Former Health and Human Services Secretary Mike Leavitt , Roll Call.
In March, NACHC’s 2017 Policy and Issues Forum saw record attendance of around 3,000 health center leaders. NACHC also released a report, “Strengthening the Safety Net,” which made the case that while the debate over insurance coverage is important, ensuring access to high-quality, affordable care is equally so. By September, with the cliff expiration date drawing near, more than 75 organizations representing doctors, nurses, hospitals, health centers, children, patients, the faith community, financial institutions and health care industry partners called on Congress to act immediately and fix the cliff [see press release]. The National Governors Association followed suit. NACHC also released an infographic which showed the impact the funding cliff was already having on health center operations even before October 1.
There was broad bipartisan agreement among lawmakers that a cliff fix should happen. Legislation to extend health center funding for 5 years was introduced in the House and Senate, but a crowded legislative calendar and arguments about offsets effectively hampered progress. Meanwhile the ranks of health center advocates (which now number over 150,000) prodded Members of Congress with thousands of emails, phone calls and office visits. The media also paid attention with headlines about the health center funding cliff in USA Today, The Wall Street Journal, U.S. News & World Report, The Atlanta Journal-Constitution, Kaiser Health News and scores of state newspapers.
“I am so frustrated that there just doesn’t seem to be any urgency about this in Washington,” — Steven Miracle, CEO of Georgia Mountains Health Services, State Health Line
“When Congress failed to fix the funding cliff on October 1, we had no choice but to institute a hiring freeze and heartbreakingly reduce staff by 15 positions,” — Ross Brooks, CEO of Mountain Family Health Centers in Glenwood Springs, CO, NACHC news conference
NACHC also hosted a conference call with media featuring health center leaders who are being affected by the funding cliff. Ultimately, as the holiday break drew near, Congress passed a short-term Continuing Resolution extending government funding through January 19th. One of the few additional provisions included in the bill was short-term funding specifically for Community Health Centers ($550 million), the National Health Service Corps ($65 million) and Teaching Health Centers ($15 million), as well as limited funds for the Children’s Health Insurance Program (CHIP). These funds represent the minimum amount necessary to maintain current services long enough for Congress to revisit this issue in January. Where do all these unresolved issues lead us? Answer: still hanging on a cliff.
Health centers continued to show their value — bringing forth innovative solutions, improving patient health at low cost and responding to disasters, such as hurricanes Irma and Harvey and a string of massive wildfires in California. They also made inroads in addressing the social determinants of health, tackling not just illness prevention but the very factors that may cause sickness, such as poor nutrition. NACHC worked with corporate partner Medtronic to address food insecurity and with CVS Health on a project to integrate addiction medicine into primary care. “Innovative Approaches for Prescription Drug Abuse Management and Prevention” is a 12-month learning community designed to assist health centers in building capacity for providing integrated behavioral health services in communities with high incidence of substance use and abuse.
National Health Center Week 2017 (NHCW) was also a success, with nearly every state in the nation, Washington D.C., Puerto Rico and the U.S. Virgin Islands participating. Nearly 700 health centers held more than 1800 events. Countless state and local elected officials also threw in their support. More than 40 states, counties and localities issued resolutions and proclamations in recognition of this year’s celebration and 80 Members of Congress participated in NHCW events, joining the celebration in recognition of the critical role health centers play in their communities.
What a year it’s been! As we bid goodbye to 2017 and look to the New Year, let us prepare to continue our collective fight for health equity, access and justice with renewed energy.