National Association of Community Health Centers Federal Policy Update

1
National Association of Community Health
CentersFederal Policy Update

• Presentation to the
• Pennsylvania Forum
• for Primary Health Care
• ___________________________
• Marc Wetherhorn
• National Association of Community Health Centers
• February , 2005

2
In the past, apathy was a moral failure. Today
it is a form of moral and political suicide." -
Dr. Martin Luther King Jr.
3
NACHCs 2004 Legislative Priorities

• Improve and preserve Medicaids viability for the
  53 million people it covers, while also
  preserving its PPS payment system for health
  centers
• Secure at least a 300 million increase in FY2006
  funding, to complete the Presidents First
  Initiative and begin his new Initiative to open a
  health center in every poor county.

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The Federal Budget Crisis(FY 2006 Budget by
Major Components, in Billions)
427
The Deficit
The Federal Budget
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Why is Medicaid Under the Gun?

• Both the federal government and the states share
  the cost of Medicaid and both are struggling
  with record deficits
• Medicaid costs 300 billion a year, making it the
  largest government health care program larger
  than Medicare and will continue growing by
  almost 10 annually
• The federal budget deficit will exceed 300
  billion/year for the next decade, unless spending
  is cut or taxes are increased
• States are also struggling with chronic and
  growing deficits, and Medicaid is now their
  largest budget item, surpassing even education
  spending

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Why Should We Care About Medicaid?

• It is the largest insurer of low-income
  Americans, covering nearly 55 million people
  today
• Medicaid pays for 1/3 of all births, and covers
  more than 1 of every 5 children, most of whom
  would otherwise be uninsured
• It is the largest single source of revenues for
  health centers
• Medicaid covers 35 of all health center patients
  and provides 35 of all revenues federal CHC
  grants only provide 22
• Cuts in Medicaid would force health centers to
  significantly cut services and care for the
  uninsured
• It is also the largest revenue source for public
  hospitals, childrens hospitals, nursing homes,
  and Pediatricians
• Most of these providers would also be forced to
  severely reduce care or go out of business
  without Medicaid

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Impact of Medicaid Cuts(Average CHC Budget -
6.4 Million)
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What is NACHC Doing About This?

• NACHC has organized a National Advocacy Campaign,
  the largest such effort it has ever undertaken
• Every health center has received an Advocacy
  Action Kit, with information on Medicaid and
  health centers, and organizing tools
• Were also working closely with PCAs, offering
  state-specific Medicaid advocacy training
  sessions
• NACHC has also organized a nationwide Coalition
  of Medicaid Providers to fight for Medicaids
  future
• The Coalition includes public childrens
  hospitals, private and minority physician groups,
  nursing homes, the cities and counties, and other
  safety net providers
• NACHC has established a national 800 number for
  calls to Congress (1-866-557-1CHC) and a Campaign
  website (www.savethesafetynet.org)

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MedicaidNACHCs Principles for Reform

• NACHC supports financial relief and some
  additional flexibility for states,
• - BUT -
• Any reform must
• Expand coverage without reducing essential
  services (especially acute care services)
• Ensure that health centers other safety net
  providers are adequately paid so they may
  continue to care for both Medicaid and uninsured
  populations
• Specifically preserve the PPS system and
  wrap-around for FQHCs

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What Can You Do to Help?

• Sign up as a Health Center Advocacy Coordinator
  or as an Advocate (see the NACHC Action Kit for
  details)
• By signing up, you will receive regular updates
  from NACHC and will be notified when action is
  needed
• Invite your Member of Congress and State
  legislators to visit your health center
• Send the message that health centers are part of
  the solution and that cutting Medicaid does not
  solve the problem in fact, it may create more
  problems
• Show them how health centers keep costs down by
  treating Medicaid patients before they get sick
  and need more costly care at hospital emergency
  rooms
• Plan to attend the NACHC 2005 Policy Issues
  Forum in Washington, DC
• Learn more about our Campaign and visit your
  Senators and Representatives to advocate for
  Medicaids future

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• Get Your Board of Directors to Pass a Local
  Resolution stressing the importance of Medicaid
  and Health Center grant funding to your health
  centers ability to care for your patients, and
  pledging to fight to preserve these all-important
  programs
• Establish a Health Center Board Advocacy
  Committee to keep up with the proposed changes in
  Medicaid or other federal funding proposed by the
  White House and Congress, and also by your
  Governors office and the state legislature, to
  organize a plan of action for responding to those
  proposed changes, and to report to the full Board
  at each meeting on what is happening
• Join the National Association of Community Health
  Centers and Your State Regional PCAs
• Invite Members of Congress to visit your Health
  Center (especially during National Health Center
  Week, August 7 13, 2005 begin preparing NOW!)

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Success (and Our Future) WillDepend on Strength
of Advocacy

• Advocacy is not just a clinical or social work
  act for individual patients, but a responsibility
  of leaders for their communities
• Advocacy involves full participation in groups
  that support your cause (PCAs and NACHC)
• This means organizational membership (dues
  support)
• Also means active individual participation
  (grassroots advocacy with state/federal
  policymakers)

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There are three types of people in the world
The people who make things happen, The people
who watch things happen, And The people who
wonder what's happening