Meanwhile, $3.6 billion in Community Health Center funding is scheduled to run out in...8 days.

I know I haven't posted much the past few days; part of this is due to dealing with the snowstorm which hit us here in the midwest (snow day for my kid, broken snowblower, etc.), while part was due to prepping for a healthcare town hall event I participated in last evening.

The town hall was centered on healthcare at the county level. Oakland County, Michigan, has over 1.25 million residents, and after decades of solid Republican control, a combination of last year's "blue wave" election plus the death of longtime GOP County Executive L. Brooks Patterson over the summer has resulted in Democrats taking control of both the executive and legislative branches of county government for the first time in forever.

County Treasurer Andy Meisner is among those running for County Exec next year, and part of his campaign involves an interesting idea to utilize a combination of federal, state & local public funding, along with partnering with private donors and local hospital systems to expand direct care healthcare coverage throughout the county. In short, he's looking to dramatically expand the number and funding of Community Health Centers to achieve something close to universal healthcare coverage county-wide.

Meisner's rationale, which I agree with, is that with partisan gridlock likely preventing any significant healthcare legislation from being implemented at the federal or state level anytime soon, it's up to us to do whatever we can at the local level. Given that Oakland County has a population greater than that of Wyoming and Vermont combined, this makes total sense.

In order to be successful, a big part of that funding would come from the federal Community Health Center Fund (CHCF), which was first established in 1965 but also had its annual budget nearly doubled thanks to a provision in the Affordable Care Act, to around $3.6 billion/year nationally.

Since the nation’s first health centers opened in 1965, expansion of the federally-supported health center system to over 1,400 organizations has created an affordable health care option for more than 28 million people. Health centers help increase access to crucial primary care by reducing barriers such as cost, lack of insurance, distance, and language for their patients. In doing so, health centers provide substantial benefits to the country and its health care system.

Health centers:

  • Provide highly efficient and cost-effective care, generating $24 billion in savings for the health care system annually.
  • Increase access to timely primary care, playing a role in reducing costly, avoidable emergency department (ED) visits and hospital stays. The average cost for a health center medical visit was less than one-sixth the average cost of an ED visit in 2012.
  • Deliver a broad array of primary and preventive care services, including screening, diagnosis and management of chronic illnesses such as diabetes, asthma, heart and lung disease, depression, cancer and HIV/AIDS.
  • Reduce mortality, health disparities and risk of low birth weight with the care they deliver.
  • Offer numerous enabling services such as transportation, translation, case management and health education in order to ensure their patients are receiving the care they need.

As noted back in January 2018, the CHC fund has had its annual funding put at risk several times over the past few years:

Congress has finally hauled the health insurance program for low-income kids to dry land, but community health centers are still out at sea.

After an unprecedented 114-day funding lapse, lawmakers voted yesterday to reauthorize the Children’s Health Insurance Program for another six years as part of the spending bill to reopen the government. But while we certainly applaud lawmakers for meeting their CHIP deadline a mere four months after the fact, let’s not forget that Congress has only really done half the job here.

Funding for the nation’s community health centers, which serve one out of every dozen Americans, also technically expired Sept. 30. These centers, which provide a range of services to the low-income population, would lose $3.6 billion this year without renewal by Congress.

It was definitely a surprise that lawmakers allowed the bipartisan CHIP program to go so long without renewal — especially because Democrats and Republicans both typically praise the program and have repeatedly voted overwhelmingly to fund it. But it’s even more shocking to some health-care advocates that Congress has permitted community health center funding to lapse this long.

After all, long-term CHIP funding has run out before (although Congress patched the program with short-term fixes), but community health centers haven't faced the same dilemma. In fact, Republicans would have beefed up community health center funding in their health-care bills last summer by diverting Medicaid dollars from Planned Parenthood clinics.

Congress eventually did fund CHCs...but only for one more year, through the end of September of 2019.

And what happened then? Well, they funded CHCs again...but only for two more months:

24 Sep Congress Provides Short-Term Funding for Community Health Centers

With just days left before the September 30th deadline, Congress passed a two-month spending package, known as a Continuing Resolution, to keep the federal government open. It was signed by the President on September 27. The bill also provides a short-term extension of funding for the Community Health Center Fund (CHCF), the National Health Service Corps (NHSC), and the Teaching Health Center Graduate Medical Education (THCGME) program through November 21st. This is an important step forward in securing long-term and stable funding for Community Health Centers, but our work is not yet done. We are going to need your continued advocacy in the weeks and months ahead in order to bring our funding across the finish line.

...Congress recognized that several other critical programs, including the CHCF, were set to expire at the same time and took additional steps to add short-term extensions of these programs to the Continuing Resolution. That is why the spending package also extends two months of funding for the CHCF, NHSC, and THCGME programs, as well as Certified Community Behavioral Health Clinics (CCBHCs), Medicaid programs in Puerto Rico and the U.S. Territories, and postpones Medicaid cuts to low-income hospitals through November 21st.

...The new deadline for both mandatory and discretionary funding for health centers and the NHSC, and mandatory funding for the THCGME program, is November 21st. In addition, the Continuing Resolution authorizes federal spending for every federal department through November 21st, preventing another government shutdown and ensuring federal agencies such as the Health Resources and Services Administration (HRSA) can continue working on behalf of health centers. Congress will then have to take action once again before the new November 21st deadline in order to ensure health center funding will not lapse at that time.

...While pushing back the deadline for funding to just before Thanksgiving isn’t ideal, the two-month extension removes the immediate threat of disruption for health centers. That said, we know that health centers across the country are already reporting indirect impacts from the threat of a lapse in funding for the CHCF, and that even with a two-month extension, the uncertainty around funding continues to pose major challenges.

Of course, funding for much of the rest of the Federal Government is also apparently set to expire on Nov. 21st as well, so...