Federal funding for health clinics that primarily serve the poor lapsed 129 days ago.
For this Congress, it’s par for the course: the Children’s Health Insurance Program (CHIP) faced a fiscal crisis for 114 days before lawmakers acted. And like CHIP, community health centers enjoy bipartisan support. Even so, continued inaction could amount to a 20 percent total cutback. So on Tuesday, advocates, dressed in red for red alert, traveled to Capitol Hill, demanding lawmakers reauthorize the fund.
“Fix the cliff” chanted advocates during the conference. They were joined by lawmakers, largely from Montana. (Over 94 percent of Montana centers serve people who live below or near the poverty level.) The movement wasn’t limited to Washington, D.C.
— Laurel HK, DNP, FNP (@la_kops) February 6, 2018
The community health center fund supports more than 10,000 clinics, which serve one in 13 people nationwide. And the hope is the money isn’t held hostage again. Inaction so far has resulted in 20 percent of health centers reporting hiring freezes and 4 percent announcing layoffs.
Advocates thought Congress would renew centers’ funding in January, when lawmakers reauthorized CHIP funding for six years. One in 10 kids on CHIP insurance receive care at these clinics. What good is an insurance card without doctors to see, clinic directors asked ThinkProgress last month. But much to their chagrin, lawmakers didn’t renew the funding.
House lawmakers are including a two-year extension of the centers’ funding in this week’s legislation to keep the federal government open, which they are set to vote on Tuesday night. The decision was meant to sweeten a stopgap bill that increases long-term funding for the Pentagon but not other critical non-defense programs.
Some lawmakers, including Sen. Jon Tester (D-MT), were hoping to extend funding for five years, in order to delay another potential funding cliff for more than one or two years. While these lawmakers appreciated House leadership for including community health centers in the short term spending bill, “the truth is we need long term funding,” Tester said during the press conference. The issue with centers is the pay-fors — shorthand for how Congress would pay for the clinics. This argument falls apart as Congress voted to pass a tax bill last year that added $1 trillion to the deficit.
Even though centers made it to this week’s short-term spending measure, it’s entirely possible for them to get caught up in political dysfunction again. While the continuing resolution may have enough votes to pass in the House, it may not in the Senate.
House R’s exiting conference confident they will pass short-term CR with full-year defense
But Senate will reject and end game unclear
— Erica Werner (@ericawerner) February 6, 2018
Community health centers are caught up in politics, as was the case with CHIP last month. Lawmakers used kids’ health insurance as a bargaining chip then. Democrats temporarily withheld their “yes” vote for a temporary spending bill that included CHIP funding because it didn’t also include critical immigration legislation. But unlike before, Democrats don’t appear dead set on shutting down the government for a Deferred Action for Childhood Arrivals fix this time around.
AltaMed’s Dr. Marie Torres traveled from California to Washington, D.C. to advocate on behalf of community health centers on Tuesday. She told ThinkProgress centers are ultimately hoping for a fix for centers and DACA beneficiaries, as these immigrants are also patients. AltaMed, which started as a free clinic in East Los Angeles in 1969, serves about 300,000 people in the Los Angeles area. Roughly 13 percent of all DREAMers live in Los Angeles, as do many DACA-eligible people.
“We don’t see this as a competing issue,” said Dr. Torres. “These are the people we are seeing in our communities.”
Uncertainty around immigration status and, thus, the toxic fear of deportation has devastating effects on the health for immigrants more broadly. Lack of legislative action on everything from DACA to medical education grants, which give graduates the opportunity to work in community health centers, jeopardize the work centers do. It all intersects, and right now lawmakers are failing centers on all counts.