On the heels of the Trump administration temporarily halting federal payments for grants and other programs last month – a move rescinded days later following public outcry – Republicans are now seeking to reduce federal spending by potentially cutting billions in funding for Medicaid. The GOP proposed a budget plan last week that targets Medicaid, which for millions of people if denied access to the health program could mean life or death. For most who qualify for Medicaid, it is their only means of health care.
The $880-billion Medicaid program – largely funded by taxpayers, which cover up to 80% of the costs in some states – provides health care coverage for an estimated 80 million low-income, unemployed and disabled adults and children nationwide, including 15 million in California alone via Medi-Cal.
Medicaid cuts could also impact millions of low-income seniors, who could experience reduced home care and community-based services, and increased out-of-pocket health care expenses.
The GOP-majority Congress is also considering work requirements for Medicaid.
Representatives of local health care organizations are extremely concerned about the potential funding cuts, which they say could impact the services they can offer in the future to the vulnerable communities they serve.
Valley Community Healthcare
“The vast majority of our patients, close to 80%, have health insurance coverage through Medi-Cal,” said Anita Zamora, RN, president and CEO of Valley Community Healthcare. “As a result, the majority of our revenue, approximately two-thirds, comes from the Medi-Cal program.”
Valley Community is a federally qualified health center (FQHC), which receives federal funding through the Health Service Resource Administration (HRSA). Currently, that funding helps cover costs for services that aren’t reimbursed by health care coverage and provides care for uninsured patients.
“Cuts to Medi-Cal would be detrimental to us, and as a result be detrimental to the health of the community,” said Zamora. “It would be challenging for us to continue doing what we are doing. We would have to make choices about cutting services and reducing the number of people we serve.”
Founded in 1970, Valley Community has locations in North Hollywood and North Hills that provide medical, dental, vision, and behavioral health care services for 21,000 low-income children and adults in the San Fernando Valley.
“We are a key part of the safety net – providing primary care, preventive services, like cancer screenings, and chronic disease management – keeping people well and out of hospitals and emergency departments,” said Zamora. After last month’s federal freeze, initially their organization was unable to draw down funds because they couldn’t access the payment system.
“Later when we did get access, it took well over a week to receive the funding, which usually comes within a day,” she recounted. “We are concerned about the impact of [future] federal funding freezes and cuts. Although we’re healthy financially, delays in federal payments from HRSA would negatively impact the flow of dollars to be able to provide patient services.”
In addition to their concerns about delayed payments and potential funding cuts, Zamora said Valley Community is currently awaiting notification about their federal community health center grant, which is typically renewed every three years; the current one is set to expire on March 31.
“Historically we would have already been notified [about the renewal] by now and we’re concerned that we haven’t been,” she explained. “As a non-profit, all of our dollars are earmarked for services – we can only weather a delay in funding for so long.”
Speaking on background, an official from another community clinic in the valley said they’re experiencing a similar lag in payments, adding that they’re concerned that any permanent funding reductions would significantly impede their ability to serve their low-income clients.
El Proyecto del Barrio
Corinne Sanchez, president and CEO for El Proyecto del Barrio, Inc. – which has evolved from an outpatient drug counseling program in the early 1970s to providing health care services – said they’ve also experienced funding delays since the short-lived freeze in late January.
“Our community suffers from heart disease, diabetes and other chronic diseases that would go unattended if they didn’t come here,” said Sanchez, noting one of their focuses is sexually transmitted diseases, including providing counseling and other services for HIV/AIDS.
Sanchez said El Proyecto has spent decades building trust across the communities they serve. She noted that if they’re forced to reduce their services or even shut down altogether, patients wouldn’t stop needing health care; they would simply be forced to go to hospital emergency rooms, which would be “cost prohibitive and result in lack of care for patients most in need.”
“This is not the first time we have been attacked, but never this directly,” said Sanchez. “These proposed cuts would totally disrupt not only that trust our patients have and their ability to get [regular] health care, but it could also impact the general health of the overall community.
“The first line of defense, the FQHCs, would be gone,” she continued. “The [health services] and costs would be transferred to the public health departments and hospitals. They’re already overwhelmed, and they would [have] added financial burdens they would not be able to meet.”
California Association of Nonprofits
Geoff Green, CEO of the California Association of Nonprofits, a statewide policy alliance of more than 10,000 nonprofit organizations, described last month’s funding freeze and proposed federal budget cuts as both abnormal and chaotic.
“We’ve weathered a century of public budget debates, and there’s always plenty of push and pull, and there are times when budgets increase and decrease – that’s what I would call normal,” said Green. “What’s happening now – freezing funding, [threatening] to gut agencies – is not normal; it’s another level. It’s chaos [and] the nonprofit sector is in the crosshairs of this administration.”
Not knowing what to expect “is a struggle for nonprofits; that is an intentional strategy,” he said.
“Chaos is part of the strategy to … strike fear into the nonprofit sector,” he added.
More than Disruption – it’s Proposed ‘Dismantling’
“It certainly shows [the current administration’s] lack of understanding about how the overall system works, from the local communities up to the state and federal levels,” said Sanchez, noting that potentially cutting billions in funding from Medicaid alone would be “the dismantling of a system that has worked and been successful with serving the poor populations that trust us.”
Sanchez said nonprofit leaders and their supporters will fight against any future cuts or freezes.
“We’re going to fight against this, whether it’s in court or on the streets by protesting,” said Sanchez. “We’re also going to fight it by educating the public as much as possible about what impact it’s going to have, not only for the poor but for the well-being of our whole community.”
this supposed to be news or an editorial?