Like many healthcare organizations across the nation, community health centers (CHC) are facing an uncertain future as our elected officials try to reshape healthcare legislation and policy under the new administration. For more than 50 years, community health centers (sometimes called Federally Qualified Health Centers or FQHCs) have been a stable presence in Kentucky’s most underserved communities.  Our stability rests on two essential pillars: community health center federal grant funding and a strong Medicaid program. Unfortunately, both of these pillars are at risk in 2017.

The 115^th Congress will convene on January 3, and the first order of business will be to repeal key portions of the Affordable Care Act, namely eliminating expanded Medicaid, subsidies for purchasing health insurance and the individual and employer mandates. This change alone will put 486,000 Kentuckians health coverage at risk. While the devil is in the details for what comes next, proposals are being made for structural changes to the Medicaid program, including block granting or per capita allotments, which have the risk to severely diminish community health centers’ ability to serve its communities.

Additionally, CHCs are facing a potential loss of 70 percent of their federal grant funding if the mandatory portion of the CHC grant program is not reauthorized by October 1, 2017. This funding cliff will hit all community health centers, and equates to more than $37 million disappearing from Kentucky’s 23 community health centers overnight.

Safety Net Cut

Hundreds of thousands of Kentuckians rely upon community health centers for healthcare, and they are the backbone of the Commonwealth’s safety net system. An uncertain future of the Medicaid program and substantial losses to the CHC federal grant funding program will erode the foundation of community health centers.

“The CHC funding cliff alone would be devastating to our health centers,” said Joseph Smith, executive director of the Kentucky Primary Care Association. “This cliff, combined with the potential changes to the Medicaid program, are the greatest threat to community health centers in more than 20 years.”

At Stake

The mission of community health centers is to provide affordable, quality healthcare to anyone in need. CHCs deliver real value to the health system; undermining their existence would have a ripple effect across healthcare providers:

• Access: 23 Kentucky CHC organizations are the medical home to more than 378,000 Kentuckians, while four CHCs in neighboring states also serve Kentucky residents. Approximately 60,000 patients in Kentucky could lose access to care if the funding cliff is realized.
• Integrated Care: In addition to primary care across the lifespan, many CHCs also provide dental, behavioral health, case management, pharmacy services and other support services that enhance care.
• Cost Savings: A recent study of CHCs’ patients with Medicaid found that patients who received the majority of their care at health centers saved an average of $2,371 in total healthcare spending compared to non-health center patients. Kentucky CHCs serve roughly one in five Medicaid patients.
• Economic Impact: CHCs in Kentucky generate positive economic impacts, including more than 2,000 full time jobs, $49 million in tax revenue, and an estimated $396 million economic impact in some of our poorest communities.
• Front Lines: In 2016, five CHCs expanded substance abuse services to help address the opioid epidemic in Kentucky.Call to Action

As leaders within our industry, we have an obligation to help shape the outcome of legislation and policies that affect our work and our patients. In the coming year, advocacy will be essential to preserving community health centers and other health programs that have become vital to our organizations and our patients.

Commit to speaking up! Contacting your legislators to express your concerns about the threats to CHCs can have a real impact on the outcomes of legislation.

“Community health centers need your help in 2017, now more than ever,” said Bill Wagner, CEO of Family Health Centers, a CHC in Louisville. “As partners in healthcare, we need your voice to let our elected officials know that community health centers, and the programs that support them are important to you.”

Learn more about important community health center policy issues and how to get involved by visiting saveourchcs.org.

–Melissa Mather is director of communications for the Family Health Centers, Inc.