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George Washington University, School of Public Health and Health Services, Department of Health Policy


Geiger Gibson/RCHN Community Health Foundation Research Collaborative Policy Research Brief No. 21


Access to Health Care; Safety Net; Underserved Populations; Government Funding; Primary Care; Community Health Centers


For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for health centers are yet to be determined. If other proposals to reduce health center funding are enacted into law, they would effectively undo health centers' ability to grow, as envisioned under the American Recovery and Reinvestment Act (ARRA) and the Affordable Care Act (ACA). This brief discusses the consequences on access and cost savings of reducing federal funding.

Building on our prior analyses of the impact of both ARRA and ACA on improving the ability of health centers to reach medically underserved communities, we conclude that the proposed $1.3 billion reduction in health center funding for FY 2011 would significantly reduce health center capacity, eliminating access for between 10 to 12 million patients. Amid concerns of continuing threats to health center funding, we also find health centers are likely to reconsider some expansion efforts and may be unable to meet the increasing demand for care, particularly as coverage is expanded.

Federal investments in health centers under ARRA and ACA were intended to strengthen and expand primary care capacity. The proposed reduction in health center funding would undermine efforts to expand access to quality care for vulnerable populations, reduce health disparities, improve birth outcomes, protect local economies, and save federal and state health care costs. Moreover, we estimate that a $1.3 billion reduction in FY 2011 health center funding would translate into a loss of approximately $15 billion in cost savings; put another way, for every one dollar in health center funding reductions, $11.50 in potential savings is lost as a result of reduced health center capacity to efficiently manage care and reduce avoidable costs.

Open Access