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As premiums rise, Community Health Centers continue to provide access to care

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On the campaign trail throughout the election season the Affordable Care Act (Obamacare) has been a popular target for criticism. Rising premiums and insurers exiting the insurance exchanges have dominated the headlines. Yet what’s missing from the conversation? Access to care. Too often we lump coverage and access together when in fact these are two vastly different, yet essential, components of good health care. Even if one is fortunate enough to have an insurance card, they still need a place to go for care. Sometimes, depending where one lives or their insurance status, finding a primary care provider can pose a problem.

The good news is that even though insurance coverage may cost consumers more, there are more medical homes where primary care services are affordable, even for patients who do not have an insurance card. These medical homes are called Community Health Centers, and they have been around for more than half a century. Services are provided on a sliding scale fee based on a patient’s ability to pay. Depending on the individual health center, a patient can receive a range of services that includes primary care, dental, pediatric care, pharmacy, behavioral health or substance addiction counseling. The success of health centers in reducing chronic disease and improving population health comes from the idea that to prevent illness, one must also look beyond the medical chart to target the factors that may cause it, such as poor nutrition, lack of exercise, homelessness, drug addiction, and even the environment.

{mosads}I doubt there is any program that has delivered more in terms of saving both lives and taxpayer dollars over the course of over the last half century.  The health care system saves $24 billion a year in reduced ER visits and hospitalizations because Community Health Centers efficiently manage and treat chronic disease, even among the most economically challenged populations. In my own state of Michigan health centers like mine save the health care system $144 per patient in Medicaid spending annually. Another more recent multistate study published in the American Journal of Public Health showed that health centers save, on average, $2,371 (or 24 percent) in total spending per Medicaid patient when compared to other providers.

The success of the Health Center Program has helped drive its growth to nearly 25 million people or one in 13 Americans. The surge is extraordinary in part because it could not have happened without the agreement among Republicans and Democrats to put more health centers in communities. Both Presidents George W. Bush and President Barack Obama were key architects of the program’s expansion over the course of their administrations. They understood that expanding affordable care is a moral imperative but, more to the point, it’s also a good investment in the public’s health.

Even with broad support for health centers there is no guarantee for long-term funding to support expanding their services. It is up to Congress to extend funding for the program, which expires next year. If that does not happen, health centers across the country face a 70 percent funding cut. Such a massive cut will bring hardship, especially for the millions of underinsured or uninsured people who struggle to get health care.

Insurers may take flight and raise premiums, but health centers are committed to remain anchored in their communities. We would be wise to continue investing in helping health centers keep their doors open so people can have affordable options for care.

Ricardo Guzman, Chief Executive Officer for the Community Health and Social Services Center (CHASS), in Detroit, Mich., and Board Chair of the National Association of Community Health Centers (NACHC).

The views expressed by authors are their own and not the views of The Hill.

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