EDITORS/NEWS DIRECTORS:
Community health centers are federally funded clinics that serve as a safety net for tens of millions of people in need of routine health care. They’re facing financial pressures from budget gaps that experts say will be exacerbated by upcoming changes to Medicaid and could lead to closures.
Also called federally qualified health centers, or FQHCs, these clinics use sliding-scale fees to serve people who are uninsured, low income, on Medicaid or otherwise would struggle to access primary care. The centers also connect people to social services and help them apply for health insurance.
The network of nearly 1,400 community health centers touches every U.S. state and territory, with service sites that extend to more than 16,000 locations. They have expanded their reach in recent years, treating 1 in 10 Americans and 1 in 5 rural Americans, according to data from the National Association of Community Health Centers.
Historically, the centers have struggled with short-staffing and competition for doctors, mental health professionals, nurses and dentists. Leaders also say funding is an ever-present concern. On average, the centers are losing money.
Upcoming changes to Medicaid, including work eligibility requirements, are expected to cause millions to lose their insurance, experts say. About half of the centers' patients are on Medicaid or the Children’s Health Insurance Program (CHIP).
“There’s nothing left to trim without cutting into care itself,” said Peter Shin, the chief science officer at the National Association of Community Health Centers.
There is also a feared spike in health insurance costs that could put pressure on the health centers and rural care as a whole.
The government shutdown, which ended Nov. 12, was driven by a Democratic demand to extend tax credits, which ensure low- and middle-income people can afford health insurance through the Affordable Care Act, or ACA.
This guide includes resources for finding community health centers near you and suggestions for covering this issue.
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SEE AP’S COVERAGE
For people in this New England mountain town, a health center’s closure leaves unanswered questions
What to know about the impacts Medicaid cuts are having on rural health care
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WHERE ARE THE HEALTH CENTERS IN YOUR STATE?
The U.S. Health Resources and Services Administration funds and collects data on community health centers.
Find the locations and data for your state here.
After selecting your state in the drop-down menu, scroll and select “program awardee data” to see statistics on patient demographic and services offered by the centers in your state. Here’s an example of what the page looks like from Alabama. The statistics go back to 2020.
Note that community health center “look-alikes” provide many of the same services as community health centers and meeting all requirements but do not receive money through the U.S. Health Resources and Services Administration. You can read more about the distinction here.
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CONSIDER EXPLORING THE FOLLOWING QUESTIONS
— What portion of your state's community health center patients are on or eligible for Medicaid? How much of a loss are the centers in your state projecting?
— Are you seeing signs of contractions? There are many steps health centers can take before a full closure, such as cutting staff or programs, pulling from their savings or only closing certain care locations, like clinics in schools or mobile clinics.
— If local health center locations near you are closing or signaling moves towards closure, what is happening to those patients? Are they moving on to similar facilities in other parts of your state, relying on hospital emergency rooms or disengaging from healthcare altogether?
— Are your local community health centers struggling with staffing? Many centers lost staff after the height of the pandemic to other jobs or retirement. Are local centers having a hard time competing for job candidates? Are there certain types of positions, like dentists, mental health experts, interpreters or social workers that are particularly hard to fill? How does that affect patients?
— What are the expected impacts of Medicaid cuts? Beyond community health centers, are you seeing cuts/closures of rural hospitals, mental health facilities and other federally-funded clinics that are being blamed on Medicaid cuts?
— What do patients think? All community health centers are required to maintain a board that is comprised of at least 51% patients. This can be a good place to start finding patient voices, in addition to a visit.
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READ RELATED AP COVERAGE
Medicaid was signed into law 60 years ago. Trump’s big bill is chiseling it back
Community health centers serve 1 in 11 Americans. They’re a safety net under stress
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