December 11, 2017

26M Americans use CHCs—which are cutting hours, freezing hiring amid expired funding

Daily Briefing

    The United States could lose up to 161,000 jobs in 2018 if federal lawmakers do not reauthorize funding for community health centers (CHCs), according to a policy brief published Monday by George Washington University's Milken Institute School of Public Health, U.S. News & World Report reports.

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    According to U.S. News & World Report, CHCs provide health care services to about 26 million uninsured and low-income U.S. residents at more than 10,000 locations throughout the country. Federal funding for CHCs expired at the end of fiscal year 2017, on Sept. 30. Congress has not yet passed legislation to reauthorize funding for the Community Health Centers Fund.

    Policy brief details

    The policy brief estimated that, without the federal funds, the United States could see a reduction of between 76,000 and 161,000 private-sector jobs in 2018, including between 32,000 and 68,000 jobs in the health care industry. According to the policy brief, 60% of the job losses would occur outside of the health care industry.

    Leighton Ku, director of the Center for Health Policy Research and a professor at the Milken Institute School of Public Health, said, "When these funds come through the economy, they don't only help the health centers themselves." Ku, who co-authored the policy brief, explained, "Health centers are like all businesses—the main thing they do is employ staff. If they have to cut back because they can't employ as many staff, or because staff have to take wage cuts, hourly reductions, whatever, employees of health centers can't go buy goods from other places," which means those entities also lose revenue. "The net effect is there are job losses and revenue loss that goes beyond the health centers," Ku said.

    The policy brief noted that CHCs also could struggle to provide services to individuals enrolled in Medicare, Medicaid, and private insurers in 2018 if the funding is not reauthorized.

    According to the policy brief, the effects of not reauthorizing federal funding for CHCs would vary from state to state, with states that have the highest uninsured populations, such as Florida and Texas, feeling the greatest effects. For instance, according to the policy brief, Texas could lose between $627 million and $1.3 billion in state gross product in 2018, as well as between 6,700 and 14,200 private jobs, if funding for CHCs is not reauthorized. The brief noted that California would see the most significant effects, losing between $799 million and $1.7 billion in state gross product in 2018, as well as between 7,400 and 15,800 private jobs. Overall, states could lose a total of up to $15 billion if the funding is not restored, according to the policy brief.

    Some health centers already feeling the effects

    According to U.S. News & World Report, some CHCs have taken action to mitigate the funding loss. Jana Eubank, associate vice president for public policy and research at the National Association of Community Health Centers (NACHC), said since the funding expired, some CHCs have reduced their operating hours and employees' wages or have frozen new hiring. She said, "We've lost some of the momentum that we had in trying to expand substance [misuse] [and] behavioral health services," as well as "other projects that are just being put on ice until Congress acts," adding, "It's just been incredibly difficult to plan or do anything at this point because we're just so unclear about the future of our funding."

    According to the Washington Examiner, HHS has estimated that not reauthorizing federal funding for CHCs could result in nine million low-income U.S. residents losing access to care. One CHC, Delaware-based Westside Family Healthcare, already has closed, U.S. News & World Report reports, and Eubank said it is likely more CHCs will close if Congress does not reauthorize the funding.

    NACHC spokesperson Amy Simmons Farber said, "There is a lot of anxiety among health centers about ensuring their patients—particularly patients living in rural areas—continue to get the care they need with so much financial uncertainty about the future" (Galvin, U.S. News & World Report, 12/5; King, Washington Examiner, 12/5; Ross Johnson, Modern Healthcare, 12/4).

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