This week we are celebrating community health centers on a national level as part of National Health Center Week. We are celebrating the community health center movement, the historic role health centers have played in community health, and the value they have in our communities – which is especially important in our current political climate.
Community health centers were founded by community health and civil rights activists who fought more than 50 years ago to improve the lives of Americans living in deep poverty and in desperate need of health care. Over the years, health centers have grown to become a model of care throughout the country — offering more services beyond just primary and preventative care, including behavioral health, prenatal care, dental care, nutrition counseling and more. Community health centers are also known for offering patients supportive services that can include nutrition education, translation services, care coordination and case management, transportation to and from health care sites, outreach and enrollment activities.
Today, more than 1,200 community health centers serve the state of California, and provide comprehensive, high quality care to 6.2 million people – one out of every seven Californians. Community health centers are economic engines within their communities. In fact, according to a 2017 report from Capital Link, California’s community health centers contributed more than $8 billion to the California economy and supported nearly 60,000 jobs in 2015. Health center staff and providers are often from the very communities they serve – giving them the unique ability to live, work and give back to their community. Health centers also provide a highly-competitive working environment that offer staff opportunities to build on and learn new skills allowing for upward mobility.
The legislation that created the community health center program also created the Medicare and Medicaid programs, all of which have helped millions of Americans access health care services. These monumental programs, along with the network of community health centers throughout the nation, laid the ground work for the Affordable Care Act (ACA) and helped make it a reality and a success nationwide. Unfortunately, that success is being threatened by the President and certain GOP members of Congress who are working to dismantle the ACA and leave millions without health care coverage. While initial proposals have been thwarted – through the amazing advocacy efforts and the GOP’s own inability to achieve agreement on this issue – the fight is not over.
In addition to the attacks on the ACA, the Trump Administration recently released its proposed budget. While it shouldn’t surprise anyone that it gives tax breaks to the wealthy, the devastating impacts to lower-income Americans and people of color is astounding. Included in these cuts are $800 million to the federal Medicaid program – a program aimed at empowering people and communities to be healthier and thrive. In California alone, 3.7 million people enrolled in Medi-Cal – California’s Medicaid program – under the ACA expansion. Additionally, more than 180,000 undocumented children have enrolled in comprehensive Medi-Cal coverage under the Health4AllKids (Senate Bill 75) expansion. All of these Californians stand to lose their coverage if these cuts to the program are realized.
Trump’s proposed budget also includes cutting the funding to programs aimed at reducing poverty. We all know that where a person lives and what resources are available to them directly impacts their quality of life. Yet, numerous programs that address these critical resources are on the chopping block. For example, Trump would like to see 25 percent ($193 billion) cut from the Supplemental Nutrition Assistance Program (SNAP) – also known as the food stamp program – over the next 10 years.
SNAP, which is called CalFresh in California, is the largest food assistance program in the nation and services about 43 million low-income individuals. Those eligible for the program generally have a gross monthly income at or below 130 percent of the poverty level. Trump’s budget proposes implementing more stringent eligibility and work requirements for SNAP recipients. And what group is the largest recipient of SNAP benefits? Children. According to the Public Policy Institute of California, children are more likely than adults to receive CalFresh assistance – in California 62.2% of low-income children ages 0 to 5, 58.7% of those ages 6 to 12, and 44.7% of those ages 13 to 17 received CalFresh benefits on average in any given month in 2014.
Cuts to SNAP are just the tip of the iceberg. Trump has also proposed cuts to the Children’s Health Insurance Program (CHIP), which provides about 6 million low-income children with health insurance, a $6 billion cut to Housing and Urban Development which provides low-income housing and a cut to the Temporary Assistance for Needy Families (TANF), also known as CalWORKs in California, which gives financial support to extremely low-income parents and children. Additionally, he’s proposed slashing funds for unemployed insurance, the Earned Income Tax Credit, Supplemental Security Income, Social Security Disability Insurance and Social Security Old-Age and Survivors insurance. These cuts to vital programs will hurt our most vulnerable populations the most – negatively impacting the ability of these communities to thrive and be healthy.
But that’s not all – health center funding is also at stake. Policymakers have long recognized the value of community health centers on a bipartisan basis, and have made investments through both Republican and Democratic administrations. A key source of funding for health centers is the Health Center Trust Fund, created by the ACA, which is comprised of both discretionary and mandatory funding and is currently scheduled to expire in September of this year. If Congress does not take action to restore the Health Center Trust Fund to previous levels, grants will be cut by more than $160 million.
While community health centers will continue to treat anyone and everyone who walks through their door, regardless of their ability to pay, the absence of these dedicated funds may force health centers to close some sites, eliminate services, and even lay off health care providers and staff. This would be truly devastating for the many communities our health centers serve throughout the nation. Health centers have been and remain the front line responders in addressing emerging public health challenges, and they generate $24 billion in savings to the health care system every year by efficiently managing and treating chronic disease, even among the most economically challenged populations.
So as we celebrate all that community health centers have accomplished over the next week, let us not lose sight of what is still at stake for so many. Cutting programs that millions of Californians depend on to be healthy is detrimental to everyone. We must remain vigilant against attacks on our most vulnerable and continue to be vocal and advocate for those that need us most. We must come together and support the programs that provide assistance and improve the quality of life of all Californians.