'Primary care cliff' threatens community health centers

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More than 100 organizations have petitioned Congress to halt cuts to community-based primary care programs before funding expires at the end of 2015.

More than 100 organizations have petitioned Congress to halt cuts to community-based primary care programs before funding expires at the end of 2015. Dubbed the “primary care cliff” in the letter written to Congressional leaders, the coalition hopes to restore funding to multiple programs during Congress’ expected lame duck session following the November elections.

Nearly 1,300 federal health center programs, serving more than 22 million patients, could see up to 70% of their budgets cut. The National Health Service Corps, which provides scholarships and loan repayment programs to primary care practitioners who work in underserved areas, could be completely defunded without Congressional intervention. Teaching health centers in 24 states supporting more than 550 medical residents who serve new and expanding communities, are also slated to close without the renewal of federal funding next year.

“The collective impact of the primary care cliff, if not addressed, would be devastating not only to the provider organizations and health professionals directly impacted, but to the patients and communities served by those providers, and to the health care system as a whole. Even now, health centers, residency programs and communities are stifled by the uncertainty caused by this looming funding cliff,” the organizations wrote in a letter to Congress.

The community health centers program received $11 billion under the Affordable Care Act. The health centers are seeking a five-year extension in funding, in hopes of serving 35 million patients by 2020.


“Congress can’t wait – this issue is simply too important for patients, communities, primary care providers and residents across the country,” says Dan Hawkins, senior vice president for policy and research at the National Association of Community Health Centers, in a press release. “This letter demonstrates a clear consensus that primary care access can’t be put at risk. When Congress returns next month, fixing the primary care cliff should be at the top of their list.”

In June, the Milken Institute School of Public Health at The George Washington University released a report stating that the number of people served by community health centers has more than doubled-the centers had 10.3 million patients in 2001, and are estimated to have 25.6 million patients by the end of 2014. Defunding the community health centers, coupled with the lack of Medicaid expansion in some states could cause a 25% drop in patients served, according to the study.

“Community health centers can only fulfill the promise of health reform if they have the resources to provide much-needed care to our nation’s most vulnerable populations,” said Feygele Jacobs, MPH, president and chief executive officer of the RCHN Community Health Foundation. “Both the Bush and Obama Administrations supported the expansion of community health centers.  Federal and state policy makers should continue to provide bipartisan support for the safety-net for needy patients in underserved areas throughout the country.”