The budget compromise struck last week by President Obama and Republicans in Congress deals a major blow to plans by community clinics in California and across the nation to expand in order to serve people who will be newly eligible for subsidized health care when the federal health reform takes effect in 2014.
The agreement will take $600 million from the anticipated growth in funding for community clinics, which were expected to play a major role in providing care as part of the federal Affordable Care Act, passed last year and under assault by Republicans in Congress.
The deal shaves that money from $1 billion that had been set aside for the expansion of community health centers, according to Carmela Castellano-Garcia, president and chief executive officer of the California Primary Care Association.
Of the remaining $400 million in that fund, $250 million is already committed, leaving just $150 million to finance new expansions for the health centers. Three hundred and fifty health centers have already applied for a piece of that money.
Castellano-Garcia said the $150 million left in the trust fund is "insufficient to allow for a significant expansion in the number of health centers."
She said community clinic supporters were surprised by the cuts because historically they have enjoyed bipartisan support in Congress. The clinics are believed to be among the most cost-effective providers of subsidized care to low-income families. About 800 community clinics operate in California.
"I am extremely disappointed with these cuts and fear that the success of the Affordable Care Act is in jeopardy as a result of these reductions," she said.
Although some advocates may be hoping that they can derail the cuts in the Senate, that appears unlikely.
Castellano-Garcia noted that Senate Democrats, on the Appropriations Committee web page, are touting the agreement as a success because it prevented any cuts in current levels of service at the community health centers.
That may be. But without new funding, the clinics could be overwhelmed when millions of new clients become eligible for health care in 2014.
Daniel Weintraub is editor of the California Health Report at www.healthycal.org.