Health centers face risks due to the drop in government financing

According to their managers, more than 1,500 health centers funded by federal funds – which offer services to millions of low -income people – are faced with significant financial challenges, as the partial closure of the government adds to other reductions in their income.

Some of these community health centers may be forced to reduce medical and administrative staff, and even services. Some could even close. Their defenders warn that this could increase the pressure on the emergency rooms of hospitals, which are already saturated with patients.

“This is the worst moment of all years I work in medical care,” said Jim Mangia, president and executive director of St. John’s Community Health, a network of 28 clinics that serves more than 144,000 patients in the counties of Los Angeles, Riverside and San Bernardino, California. “We are faced with federal cuts and extreme cuts at the level of the state that will affect the services.”

St. John’s and other skilled health centers at the federal level provide primary care and a wide range of other services without costs or prices adjusted to the income of each patient. At the national level, they serve around 34 million people in the country’s most unattended areas.

The federal funds come from two main sources, both currently under pressure: the subsidies granted in part through the health center, federal and reimbursement of patients through programs such as Medicaid, which offers medical coverage to low income or disabilities.

Medicaid articulates states and the federal government jointly.

In recent times, the congress has approved these funds with drops. In March, legislators extended subsidies until September 30. This money expired after the Congress, controlled by the Republicans, does not approve of a financing law, which caused a partial closure of the government.

Defenders of the centers point out that long -term financing is necessary to be able to plan a greater certainty, ideally in a mlannual environment.

The health centers received $ 4.4 billion in subsidies at the beginning of 2024. The National Association of Community Health Centers was pretending to be awarded at least 5.8 billion dollars per year for two years, in order to maintain fully operational centers.

The security network representing health centers “faces several layers of challenges,” said Vacheria Keys, vice-president of association policies and regulatory affairs.

The new law on public spending that Republicans call “a major bill” will imply important cups in Medicaid, which imposes another important threat to these centers.

In 2023 Medicaid represented 43% of the $ 46.7 billion in total health centers.

Defensores warns that the reduction of Medicaid payments will aggravate the gap between available funding and operating costs.

The financing of staff development programs is also necessary, to support the provision of health services, since the centers face difficulties in hiring and retaining workers, said Feygele Jacobs, director of the Geiger Gibson program in community health at George Washington University.

The first centers of this type opened in places like Massachusetts in the 1960s. Historically, Congress financed them by bipartite support, with some minor obstacles.

The current crisis began when the Trump administration froze national aid thanks to a memorandum published in January, which prevented certain centers from receiving already approved subsidies. Consequently, certain centers have closed or merged into states such as Virginia.

The next cups will also arrive when patients face new requests and challenges. Among the Medicaid changes included in tax law and expenses of President Donald Trump is the requirement that beneficiaries report their hours of work or other community activities to be able to keep their coverage.

Meanwhile, the most generous subsidies that the Biden administration and the Congress had approved to help consumers pay the medical plans acquired in the insurance markets under the low -cost health care law (ACA) should expire at the end of the year.

If the congress does not renew them, certain consumer costs will increase considerably.

One of the reasons for the government’s closure is that Democrats want to extend these subsidies, who protect consumers from the increase in insurance costs. The republican financing bill did not include extension; Congress Republican leaders say that this question should be discussed separately.

“Consumers will need more support than ever,” said Jacobs, who warned that the Medicaid cuts and the end of improved grants could “leave many people without coverage”.

90% of patients in community health centers have income from the federal or less level, and 40% are Hispanic.

“We receive 300 calls to patients worried about their coverage,” said Mangia, from St. John’s.

The Republicans do not directly attack the centers, although they have supported the MEDICAID cuts which will affect their finances. Many maintain that Medicaid spending has triggered and that the reduction in its growth will make the program more sustainable.

State and local support

While advocating more stable federal funding, the centers also seek the support of their local communities and governments.

Some states have already taken measures at the end of their annual budgets. Connecticut, Minnesota, Illinois and Massachusets have allocated funds to the centers. Maryland, Oregon and Wisconsin have also offered support.

The question of million is the duration of the duration of this money.

While some states have increased their support to the centers, others take the opposite direction. Anticipating the impact of Medicaid cuts, states and California have made their own cuts on the program.

The Governor’s office of California, Gavin Newsom, as well as the federal health resource and services, did not respond to requests for comments.

In Los Angeles, Mangia said that a possible solution was to work with allies at the county level and stressed that the County of Los Angeles has around 10 million inhabitants.

“We can impose a tax to increase the financing of health services,” he said.

The leaders of the centers form a coalition which, “waits”, includes the main players in the county health system: community centers, clinics, hospitals, doctors, health plans, unions. The objective: to initiate the process to present a citizen initiative which allows voters to decide if they wish to approve a tax intended to finance the health centers.

“We learn that the federal and state government is not reliable with regard to the guarantee of continuous financing of health services,” said Mangia.