Fix the health center ‘funding cliff’

A potential 70% cut in federal funding would devastate the ability of community health centers to provide services


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Community health centers in New Hampshire and across the nation are at tremendous risk. Without Congress’s action by Sept. 30, health center funding will immediately be cut by 70 percent.

The National Health Service Corps (NHSC) funding, which goes hand-in-hand with the health center funding by supporting providers dedicated to working in underserved areas, will be eliminated. Nationally, the Department of Health and Human Services estimates that this “funding cliff” could lead to about 3,000 health center sites closing their doors, 50,000 Americans losing their jobs, and 9 million losing their health care.

In New Hampshire, 12 federally funded health centers provide primary care, substance use disorder treatment, oral health services, and behavioral health services to over 89,000 citizens in underserved areas. Granite Staters will lose access to health care services when we need them the most, in the midst of an opioid epidemic, if the funding cliff isn’t fixed.

Community health centers save the American health care system billions of dollars every year ($1,263 per patient per year) by keeping people healthy and out of hospital emergency departments. Research has found that a substantial proportion of ER visits are either non-urgent or could have been avoided through timely primary care. Health centers play a vital role in reducing these avoidable ER visits by providing accessible, continuous and comprehensive primary care, especially to those at risk of using the ER for avoidable or preventable care.

Health center funding is specifically designed to provide access to care for patients in communities where doctors and services are scarce or non-existent. A 70 percent reduction in the funding of New Hampshire’s health centers means an estimated loss of nearly $16 million, with almost half of health center patients in New Hampshire losing access to health care.

Health center leadership in New Hampshire described a loss this big as “devastating,” as they would have to close sites, change their sliding fee discount programs, and eliminate services including dental and substance use disorder treatment.

For example, one CEO whose health center is located in an urban section of New Hampshire devastated by the opioid crisis, would have to terminate all services outside of primary care – leaving 2,200 patients who receive their dental, pharmacy, behavioral health, and substance use disorder care at this center with no place to turn.

The “funding cliff” also encompasses elimination of the NHSC funding, which allows primary care medical, dental and behavioral health clinicians to repay their health student loans in exchange for a two-year commitment to work at an approved NHSC site in a high-need, under-served area.

Over 55 percent of NHSC loan repayment awards are made to providers working in community health centers. NHSC funding is a critical resource for health centers in recruiting competent clinicians and attracting them to New Hampshire because it is more difficult to recruit clinicians in the rural and underserved areas of our state.

Our state is already experiencing a primary care workforce shortage with 132 reported health center and safety net provider vacancies. Any lapse in NHSC funding will be catastrophic for clinical field strength in New Hampshire.

I urge you to support the continuation of health center and NHSC funding so that health centers can continue to serve New Hampshire communities and patients. Please call your members of Congress (dial 1-866-456-3949) to ask them to fix the “funding cliff.” The health of the Granite State depends on it.

Tess Stack Kuenning is president and CEO of Bi-State Primary Care Association.

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