
{"id":27012,"date":"2012-07-19T09:51:39","date_gmt":"2012-07-19T13:51:39","guid":{"rendered":"http:\/\/www.carrborocitizen.com\/main\/?p=27012"},"modified":"2012-07-19T09:51:39","modified_gmt":"2012-07-19T13:51:39","slug":"aca-decision-leaves-questions-for-health-centers","status":"publish","type":"post","link":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/2012\/07\/19\/aca-decision-leaves-questions-for-health-centers\/","title":{"rendered":"ACA decision leaves questions for health centers"},"content":{"rendered":"<p><strong>By Susan Dickson<\/strong><br \/>\n<em>Staff Writer<\/em><\/p>\n<p>The Supreme Court decision affirming the Patient Protection and Affordable Care Act last month made clear, under law, that a vast number of uninsured Americans should obtain health coverage, one way or another, by 2014. <\/p>\n<p>For community health centers, whose mission is to provide affordable primary care to everyone \u00e2\u20ac\u201c including those who can\u00e2\u20ac\u2122t pay for it \u00e2\u20ac\u201c\u00c2\u00a0that expansion of coverage would bring many of their uninsured patients into some type of health coverage, be it Medicaid \u00e2\u20ac\u201c the joint state-federal insurance program for low-income Americans \u00e2\u20ac\u201c or health insurance subsidized under the PPACA. <\/p>\n<p>But given the court\u00e2\u20ac\u2122s ruling that the act\u00e2\u20ac\u2122s provision expanding Medicaid eligibility will be optional for states, that coverage remains somewhat in limbo. <\/p>\n<p>Community health centers receive federal funding to provide care to the uninsured. When the PPACA was signed into law by President Obama in 2010, the $11 billion community health center fund was established, paving the way for the expansion and construction of health centers across the country. The funding was scheduled to be provided over a five-year period, to coincide with the increase in patients the health centers are projected to see as more Americans become insured by 2014.  <\/p>\n<p>And in 2016, after various provisions of the PPACA are in place \u00e2\u20ac\u201c including the Medicaid expansion \u00e2\u20ac\u201c federal funding to health centers is set to decrease, given that many health center patients would no longer be uninsured, said Benjamin Money, president and CEO of the North Carolina Community Health Center Association. <\/p>\n<p>\u00e2\u20ac\u0153Most of the patients that we would see that are uninsured would be covered by the Medicaid expansion,\u00e2\u20ac\u009d he said. \u00e2\u20ac\u0153Then we would need less federal funding to cover the uninsured because they would have an insurance source \u00e2\u20ac\u201c Medicaid.\u00e2\u20ac\u009d<\/p>\n<p>However, should the state decide against expanding Medicaid, many patients will remain uninsured, but the federal funding provided to help pay for their care will no longer exist, Money said, creating a serious challenge for the state\u00e2\u20ac\u2122s community health centers.  <\/p>\n<p>The provision to expand Medicaid eligibility would include anyone making less than 133 percent of the federal poverty level. For North Carolina\u00e2\u20ac\u2122s community health centers, the Medicaid expansion would provide coverage for 40 percent of health center patients, with an additional 15 percent covered by subsidized insurance, Money said. <\/p>\n<p>Given that 52 percent of their patients are uninsured, the expansion of coverage means a lot to the state\u00e2\u20ac\u2122s community health centers, he added. <\/p>\n<p>\u00e2\u20ac\u0153One of the challenges is, because the Affordable Care Act is a lot of moving parts, if you take out one of the parts \u00e2\u20ac\u00a6 it\u00e2\u20ac\u2122s not going to work,\u00e2\u20ac\u009d Money said. <\/p>\n<p><strong>An influx of patients<\/strong><\/p>\n<p>North Carolina\u00e2\u20ac\u2122s 34 community health center organizations, with 160 sites statewide, provided care for about 450,000 patients in 2011. With the Medicaid expansion \u00e2\u20ac\u201c should North Carolina lawmakers opt in \u00e2\u20ac\u201c\u00c2\u00a0and large numbers of newly insured patients, the NCCHCA expects that number to grow to nearly 800,000. <\/p>\n<p>Brian Toomey, CEO of Piedmont Health, a Carrboro-based community health center organization with seven locations in the Piedmont region, said his organization has been working to expand over the past couple of years, given that demand is already so high that they turn people away each day. Fifty-nine percent of Piedmont\u00e2\u20ac\u2122s patients are uninsured, a percentage that would drop sharply with the Medicaid expansion.<\/p>\n<p>Piedmont\u00e2\u20ac\u2122s Carrboro location is especially busy, Toomey said, and the organization has begun looking for a second site in the Carrboro-Chapel Hill area. That site will be needed even more as the PPACA goes into place. <\/p>\n<p>\u00e2\u20ac\u0153Our challenge is going to be making sure we have facilities,\u00e2\u20ac\u009d Toomey said, noting that Piedmont is also ramping up its recruitment program and adding jobs. <\/p>\n<p>In addition, Piedmont is focusing on strengthening its partnerships within the community, Toomey said, like those with UNC and the Orange County Department of Health. <\/p>\n<p>\u00e2\u20ac\u0153Alone, none of us can do this,\u00e2\u20ac\u009d Toomey said. \u00e2\u20ac\u0153When we leverage [partnerships], the community is much better served.\u00e2\u20ac\u009d <\/p>\n<p>Money said community health centers, while not yet prepared for the projected increase in patients, will continue to provide care to everyone. <\/p>\n<p>\u00e2\u20ac\u0153Are we prepared in North Carolina? No. Will we figure it out? Yes,\u00e2\u20ac\u009d Money said.<\/p>\n<p>\u00e2\u20ac\u0153There\u00e2\u20ac\u2122s going to be some growing pains,\u00e2\u20ac\u009d he continued. The increase in patients seeking care that they\u00e2\u20ac\u2122d likely deferred for some time will inflate costs initially.<\/p>\n<p>\u00e2\u20ac\u0153It\u00e2\u20ac\u2122s really that built-up demand and built-up need,\u00e2\u20ac\u009d he said, adding that further deferring care would only drive up eventual costs more. <\/p>\n<p>At this point, Money said he hopes state lawmakers and others will get onboard with the PPACA.   <\/p>\n<p>\u00e2\u20ac\u0153If you\u00e2\u20ac\u2122ve got people that have a focus of dismantling health reform at all costs, regardless of who wins the election, if there\u00e2\u20ac\u2122s a dismantling effort going on as you\u00e2\u20ac\u2122re trying to roll it out, that\u00e2\u20ac\u2122s like trying to drive the car down the road while someone\u00e2\u20ac\u2122s trying to take the tires off.\u00e2\u20ac\u009d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A vast number of uninsured Americans should obtain health coverage, one way or another, by 2014. <\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-27012","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/27012","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/comments?post=27012"}],"version-history":[{"count":1,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/27012\/revisions"}],"predecessor-version":[{"id":27013,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/posts\/27012\/revisions\/27013"}],"wp:attachment":[{"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/media?parent=27012"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/categories?post=27012"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ibiblio.org\/carrborocitizen\/main\/wp-json\/wp\/v2\/tags?post=27012"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}