National Association of Community Health Centers and The George Washington University
March 2005
Growing Uninsured, Budget Cutbacks Challenge President’s Initiative to Put a Health Center in Every Poor County
By Michelle Proser, Peter Shin and Dan Hawkins
Given the Bush Administration’s new goal of expanding health centers into every poor county in the country, the National Association of Community Health Centers (NACHC) and the George Washington University identified poor counties that are “unserved” in that they lack at least one health center. A total of 929 counties around the country fit these criteria. These poor, unserved counties represent almost a third of all US counties and more than half of all poor counties.
The number of communities needing a health center far exceeds available resources. For instance, available funding for FY 2002 and 2003 allowed only one out of three qualified applications for new health center sites to be approved for funding. In FY 2004, less than one in ten of qualified applications were approved. Moreover, while inflation-adjusted federal funding between 2002 and 2003 increased by 7%, the number of uninsured patients at federally-funded health centers rose by 11%. Many health centers around the country are reporting significantly higher growth in the proportion of uninsured patients. For every one uninsured, low income patient that a health center treats, there are four others needing their services, not to mention countless others lacking access to regular primary care regardless of insurance status. Compounding the need is rising poverty.
Given these multiple factors, there are not enough health centers for the people and communities who need them. Of course, in order to improve health on the greatest scale, the preservation of insurance is equally important. Expanding both insurance coverage and the health center program are needed to improve access to care,and both approaches are in fact complementary. Health centers provide services that many other providers do not, such as enabling services, making them preferred providers for many patients.
President George W. Bush (January 27, 2005, Cleveland, OH):
“.here are some practical ways for us to deal with the rising costs in health care. One is to make sure that people who can’t afford health care have got health care available to them in a common-sense way. And that’s why I’m such a big backer of expanding community health centers to every poor county in America. We really want people who cannot afford health care- the poor and the indigent – to be able to get good primary care at one of these community health centers, and not in the emergency rooms of the hospitals across the United States of America.”
http://www.nachc.com/research/Files/poorcountiesSTIB9.pdf
Comment: In 2004, over 90% of qualified applications for community health centers were rejected because of lack of available funding. Is it fair to ask the president what he means when he says that he’s “such a big backer of expanding community health centers”?