The funding marks the last big round of grant awards this fiscal year under a provision of the Patient Protection and Affordable Care Act. In June, HHS awarded $300 million in grant funding to health centers to expand care for 1.25 million new patients. In July, the agency awarded $100 million that it estimated would help to support up to 150 new health center sites mostly in medically underserved areas.
“Health centers are a key part of how the Affordable Care Act is working to improve access to care for millions of Americans,” Burwell said in a statement.
Indeed, health centers say that the influx of new patients newly covered under the healthcare reform law has put them in desperate need of more resources to handle the volume.
“It could not come at a more important, opportune and critical time,” said Daniel Hawkins, vice president of federal, state and public affairs for the National Association of Community Health Centers. “Every health center I talk to around the country is bursting at the seams with new folks coming in to see them in states where they've expanded coverage like in California and New York.”
The grant awards are part of $3.7 billion in total appropriations Congress allocated to health centers in January, representing a $700 million increase over last year. Aside from a onetime increase of $2 billion in 2009 as a result of the stimulus law, health center funding had increased very little since 2003. That changed in 2011, when the program got a large annual boost with the implementation of the Community Health Care Fund under the Affordable Care Act, which has provided $11 billion in additional funding from 2011 to 2014 for expanding community health center services to accommodate the millions who gained health coverage as a result of the health insurance marketplaces and the expansion of Medicaid.
There are nearly 1,300 community health centers across the country, and they operate more than 9,000 delivery sites that provide care for more than 21 million patients. According to figures from the National Association of Community Health Centers, about 76% of patients who visit a community health center are uninsured or covered through either Medicaid or the Children's Health Insurance Program. Overall, almost three-quarters of all health center patients are low-income, earning up to 100% of the federal poverty level.
Hawkins said he hoped health centers would use the grant funding toward increasing their hours of operations in order to better serve their patient populations.
“Healthcare is the last place in America that still operates on bankers' hours,” he said. “We need to operate healthcare with hours that are available, accessible and convenient to people.”
But the funding that made the current round of grants possible—and accounts for up to 70% of a health center's total federal grant allocation—is set to expire next September. Hawkins is concerned that many of the gains that have been made toward expanding access to primary care might be in jeopardy if lawmakers fail to fund health centers at a level that enables them to sustain the increases in demand seen.
Hawkins said many health centers would be forced to reduce their scope of services or raise their sliding-scale charges, which would create barriers to access, with the biggest impact occurring in states that have not expanded Medicaid to adults earning up to 138% of the federal poverty level.
“The reality is that there are few health centers in America that could continue their operation at current levels if that grant funding was cut,” Hawkins said.
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