Dr. Ron Yee, the chief medical officer at United Health Centers of the San Joaquin Valley in Parlier, Calif., said the key is for congressional leaders to get to the health centers. “If they actually see what we're doing and talk to some of the patients and clinicians, that's how you get a real champion,” he said.
Victoria Reggie Kennedy, widow of the late Sen. Edward Kennedy (D-Mass.)—a longtime champion of federal health centers—noted to attendees at the conference that President George W. Bush “supported these sites dramatically.” During Bush's first term, HHS' Health Resources and Services Administration launched the President's Health Center Initiative in 2002, which achieved its goal of establishing new or expanded health-center sites in 1,200 communities.
But as the country is readying itself for an expansion of Medicaid, the proposed reductions would compromise community health-center operations, according to Yee. Sebelius also mentioned this boost in Medicaid rolls when she spoke at the NACHC conference. As the new law expands coverage to 32 million more people, Sebelius said, nearly half of those will be covered through Medicaid and will have a card “helping you to become reimbursed,” she told attendees.
Rep. Michael Burgess (R-Texas), a physician, said in an interview that he supports community health centers, although he said “it was quite a challenge” for a federally qualified health center to be approved in his district of Fort Worth, and that “the bureaucracy remains a point of concern for me.” For example, Burgess questioned the number of administrative staff hired per clinician. At United Health Centers in California, Yee said, one front-office employee is hired for every two clinicians.
As for a reason why House Republicans have proposed a steep discretionary spending cut for community health centers, the Affordable Care Act offers some insight. “Community health centers are funded quite lavishly in the bill,” said Burgess, a member of the House Energy and Commerce Health Subcommittee, which recently held a hearing that examined mandatory and discretionary spending levels for certain programs in the Affordable Care Act (March 14, p. 8). Republicans on the committee assert the mandatory spending gives too much authority to HHS and is seeking to revert that control back to Congress.
“The amount of money that has been funded,” Burgess said of the community health-center funding in the law, “may have been more than Congress would have appropriated.”