The latest inability of Donald Trump’s US Health Bill to make it through Congress doesn’t mean that the Affordable Care Act a.k.a. Obamacare is in the clear and a new study has shown that repeal of key provisions in Obamacare would cause catastrophic funding losses for community health centers.
The report is the first one that analyses the potential effects on medically underserved communities of the types of health insurance losses that has been proposed by the Trump administration in the new bill. The Congressional Budget Office in one of its projections said that the American Health Care Act as introduced on March 6th and now yanked from Congress would eliminate health insurance coverage for 24 million people by 2026.
At risk are ACA expansions of private insurance subsidies, and cuts to the Medicaid program, which is a key source of insurance coverage for health center patients, providing coverage to just under half of those served by community health centers in 2015. Reductions of the magnitude forecast by CBO could trigger deep reductions in health center services, according to the report from investigators at the Geiger Gibson/RCHN Community Health Research Collaborative at the George Washington University’s Milken Institute School of Public Health (Milken Institute SPH).
Researchers set out to find how reversal of the coverage gains and increased funding made possible by the ACA might affect community health center revenue, staffing, and patients. The team surveyed community health centers between January and February 2017 capturing information from a representative group of nearly 600 centers in all 50 states, the District of Columbia and three U.S. territories.
Findings indicate there will be massive impact on patient care with reduced hours, site closures, and service reductions driven by revenue cuts that will translate into fewer people served. On top of that there will catastrophic financial effects found the survey with more than 80 percent of community health centers estimate financial losses exceeding 20 percent, and nearly half (47 percent) estimated that they would experience revenue losses of more than 40 percent.
The financial effect will also translate into staff layoffs with community health centers would be forced to lay off mission-critical staff, including doctors, nurses and others who provide care to high-risk, vulnerable people in underserved rural and urban communities. The expected reductions averaged 34 positions per health center.
All these combined will case reduction in service with virtually all community health centers stating that they would have to pare down or cut services in response to funding losses of this magnitude. General medical services would likely be reduced, while much-needed mental health care and treatment for substance abuse, nutrition and health education, care management for chronic health conditions, and services to promote access, would be at greatest risk of being eliminated entirely.