Congress has quietly created a new health care crisis for 26 million Americans

They let funding for community health centers lapse 124 days ago.

By Sarah Kliffsarah@vox.com  Feb 2, 2018, 8:20am EST

Last fall, Kim Wagenaar started to plan how she would close the health clinic she runs in rural North Carolina — when Congress let funding lapse for thousands of centers like hers 124 days ago and counting.

The Cabarrus Rowan Community Health Center offers primary care services to patients, largely uninsured and unable to afford visits elsewhere. Its four buildings, scattered across suburban Charlotte and more rural areas to the north, do not suffer from low demand. They saw more than 8,000 patients last year alone.

“I’m usually a very optimistic person,” Wagenaar says. “I always feel like the community health centers have great support. But I’ll be honest, this is the first time I’m not 100 percent sure this will get fixed.”

Matilde Gonzalez (left) and Cesar Calles hold their son, Cesar Julian Calles, 10 months old, as Ana Martinez, a medical assistant at the Sea Mar Community Health Center in Seattle, gives him a flu shot on January 11, 2018. Ted S. Warren/AP
Nationally, millions of Americans visit community health centers each year. An estimate from 2016 found the 2,000 centers provided care to 26.5 million people. They rely heavily on federal funds that have passed with bipartisan support in recent decades. George W. Bush expanded the program, and the Affordable Care Act made another big investment in them.

But this fall, the $3.6 billion budget lapsed at the same time as the Children’s Health Insurance Program. CHIP, which provides coverage to millions of poor children, just got its funding back in late January. But community health centers were not included in the deal.

Legislators from both parties have said they want to extend the health centers’ budget. But so far, they haven’t. If they don’t do it very soon, health care access will decline for potentially millions of vulnerable Americans.

George W. Bush and Barack Obama were both ardent community health center advocates
Community health centers began as a tiny experiment in Mississippi and Massachusetts in the 1960s, a small element of President Lyndon B. Johnson’s war on poverty.

An enterprising young doctor named H. Jack Geiger had done work in South Africa and saw the difference that access to primary care could make for underserved communities.

Four decades later, it was George W. Bush who pushed for a major expansion of the program. As the New York Times reported in 2008, the president “came to admire the missionary zeal and cost-efficiency of the not-for-profit community health centers” and “proposed to open or expand 1,200 clinics over five years (mission accomplished) and to double the number of patients served (the increase has ended up closer to 60 percent).”

President Obama followed up on the Bush-era expansion with increased community health center funding through the Affordable Care Act. With the law expanding coverage to millions, the Obama administration wanted to ensure that the newly insured would have adequate access to medical services.

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https://www.vox.com/policy-and-politics/2018/2/2/16936916/community-health-centers-congress