Millions of low-income Americans would lose access to primary healthcare if an expiring funding provision in the Patient Protection and Affordable Care Act is not extended, a study warns.
Advocates for extension say the impact of letting the provision expire on Sept. 30, 2015, would be felt across the healthcare system in the form of higher rates of emergency department utilization and hospital admissions.
Not extending the ACA funding provision could lead some of the country's 1,300 centers to shut down, said Leighton Ku, a professor of health policy at George Washington University. “We know that there is a growing shortage of primary-care physicians,” Ku said. “If health centers aren't there, it will mean that this becomes that much worse and it will principally affect low-income people.”
The number of Americans served by community health centers could drop from 25.6 million in 2014 to 18.8 million by 2020 if no additional states were to expand Medicaid by 2020 and if the mandatory funding allocated by the ACA is not extended, according to Ku's study released last week by George Washington University.
The centers, which have about 9,000 sites across the country, are considered a key source of primary care for many Americans who gain insurance under the Affordable Care Act, as well as for the uninsured, since they serve people regardless of ability to pay. The centers are dependent on two major funding streams—federal, state and local grants and contracts, and Medicaid, each of which made up approximately 39% of the $15 billion in total revenue clinics received in 2012, according to the study.
The bulk of grant funding that community health centers receive comes from the federal Bureau of Primary Health Care in the form of Section 330 grants under the Public Health Service Act. An ACA provision provided a cumulative total of $11 billion in mandatory funding from 2011 to 2014 in addition to the regular annual discretionary appropriations for the centers.