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The Health of 30 Million Depends on a Four-Legged Stool

Released in tandem with this week’s virtual 2021 Policy and Issues Forum is a new issue brief that explains the funding and policies that are essential to the work of Community Health Centers. COVID-19 exposed just how thin the financial margins can be among health centers. And just as we hope that the pandemic will soon be over, there is a case to be made for continued and sustained investment in the health center program that is increasingly being called upon to counter public health challenges.

“A tapestry of policies and resources collectively support the efforts of health centers to deliver and rapidly expand needed medical care, behavioral health, dental care, pharmacy, social, and other services to individuals and families who would otherwise go without,” writes Sarah Baizer, Research and Data Manager of NACHC and co-author of the Issue Brief.

“They also allow health centers to pivot and respond to emerging public health crises – such as the COVID-19 pandemic – and natural disasters while maintaining primary and preventive operations for communities where health care options are few or scarce.”

Running a vast system of care requires multiple and diverse funding and policies to support it, much like a four-legged stool. These legs include:

• Federal Health Center appropriations;
• Medicaid;
• Savings from the 340B Drug Discount Pricing
Program; and
• Recent federal COVID-19 emergency relief.

Without all four legs in place, the stool will not balance. And balance is essential for a system of care on which 30 million people depend, especially in times of crisis and chaos. Health centers depend on mandatory and discretionary funding from Congress, (the latter of which is decided each year), and Medicaid reimbursement for services.

How these factors work together largely depends on the constantly shifting political climate in Washington and in the states. Few may realize, as the brief notes that, “one-fifth of all people in the U.S. who  rely on Medicaid for insurance coverage get  their  care at health  centers, where they  comprise half the patient population.” The longstanding partnership between Medicaid and health  centers allows  them to improve outcomes as well as accrue savings, as they  save around $2,400 per Medicaid  patient.

We note that the NACHC issue brief comes on the heels of health centers’ rollout of a massive vaccination effort against COVID. They have been tapped by the Biden Administration to ensure equity in protecting hard-to-reach populations from COVID-19, such as communities of color, migrant and agricultural workers, the poor, public housing residents and people who have language barriers.

The recently enacted American Rescue Plan will provide an infusion of much-needed resources– including 7.6 billion in flexible emergency COVID-19 funding—  as health centers mark one year of fighting the pandemic on the frontlines. As welcome as this relief is for health centers, it is one-time funding. Congress will need to provide billions more to ensure health centers remain open and available for needed preventive and chronic care for the millions of newly jobless and uninsured, and to COVID-19 vaccination efforts and testing until we’ve reached the end of the pandemic.