Community health centers (CHCs) have traditionally enjoyed bipartisan support: they provide high-quality, cost-effective care to anyone who needs it, in nearly every congressional district, regardless of a patient’s ability to pay.
These community-based outpatient clinics provide primary, behavioral, maternal, and dental health care to more than 31 million people. In some cases, they are the sole source of care in a community. CHCs provide timely access to primary care, produce a quality of care similar to private practices, reduce mental health-related emergency department visits, give patients a place to go when rural hospitals close, and more. They employ hundreds of thousands of residents, strengthening local infrastructure and generating billions of dollars in local revenue.
The new administration and Congress are seeking to improve efficiency in the financing and delivery of health care. This is a laudable yet challenging goal, particularly given increasing costs in the U.S. relative to affordability challenges.
CHCs and their ability to provide efficient, cost-effective care could help address these goals. The Congressional Budget Office found that greater federal investments in CHCs could save billions of dollars for Medicaid and Medicare.
Yet, recent federal and Congressional actions have reduced investment in CHCs and placed their daily operations and the well-being of patients and staff at risk. These include:
- Freezing federal grants funds, resulting in immediate center closures and staff layoffs.
- Reducing the congressionally authorized Community Health Center Fund, a main source of federal funding for CHCs, to an annualized rate of $4.26 billion from $4.4 billion, despite a higher number of sites operating and a record-high number of patients compared to past years.
- Reducing the workforce and reorganizing the Health Resources and Services Administration (HRSA), the agency that promotes innovation and growth among CHCs through workforce development, technical assistance, data collection, and infrastructure development.
- Removing from the HRSA website high-quality, transparent, and reliable data on the quality, spending, and workforce of CHCs. These data are used to promote care delivery improvements and make targeted investments.
- Proposing billions of dollars in cuts to Medicaid funding, which makes up around 42 percent of CHC revenues.
Before these cuts, there was reason to worry about CHCs’ financial outlook. Experts had estimated that CHC costs would exceed revenues, requiring additional investments from the government. Recent Commonwealth Fund research found that nearly half of centers expected their total amount of uncompensated care to increase; one-quarter expected their financial stability to worsen.
The impact of the government’s recent actions could be devastating, leading to funding shortfalls and center closures. Further, without dedicated federal staff overseeing CHCs and ensuring they receive their congressionally authorized funding, centers might have to cease their daily operations. Patients, particularly those in communities without other health care options, could be left without access to valuable health care services, including chronic care management, behavioral services, or maternal health care.
As health care spending climbs in the United States, finding cost-effective solutions while improving health care outcomes is essential. Evidence shows that greater investment in CHCs can achieve this, while cuts to these valuable services will be detrimental.
