Congressional failure on CHIP, health center funding is a disgrace

Members of Congress will still be able to see their medical providers if they continue to neglect a critical responsibility: extending funding for a vital public health program serving rural and urban communities. Unfortunately, the 3,000 patients now served by Moorhead, Minn.-based Community Health Service Inc. may not be able to say the same beginning in early 2018.

Congressional inaction could cause clinic doors to close or services to shrink in one or more of Community Health Service's main locations: Moorhead, Willmar, Rochester and Grafton, N.D. Two of its mobile clinics serving regional farmworkers may also wind up going nowhere.

"It's getting harder to keep our hopes up,'' said Executive Director Kristi Halvarson, whose organization will be among the first community health centers in Minnesota to see federal dollars dry up. Along with other community-center advocates, Halvarson began lobbying Congress last March to reauthorize funding that expired in September.

The uncertainty hovering over Community Health Service and 1,400 organizations like it nationwide is a disgrace. Thousands, even millions of the nation's neediest patients served by providers like these may soon be scrambling to find care if legislation isn't swiftly passed to keep grants flowing to what are known as "federally qualified health centers.''

Minnesota has 17 such organizations providing care at 70 locations. Nationally, there are more than 9,000 community health care center sites serving 23 million patients. Congressional funding has been routine because of these centers' noble mission — providing care to underserved urban and rural communities without regard for patients' ability to pay.

In 2015, Congress approved $3.6 billion over two years with minimal fuss. There is no good reason this year should be any different. Yet funding for these centers and another vital medical assistance effort, the Children's Health Insurance Program (CHIP), has been bogged down since fall despite broad bipartisan support for both.

CHIP serves 125,000 Minnesota kids, with a total of 5.9 million enrolled nationally at an annual cost of $15.6 billion. Along with community health centers, it's part of the nation's medical safety net. Even though the House recently passed funding for both programs, Senate passage remains unclear. A key reason: The House bill pays for the two programs with dollars taken from other important public health programs.

While other states have sent out notices warning CHIP enrollees about possible coverage disruptions, most Minnesota families relying on the program thankfully won't need to worry. If federal funding isn't approved, the state will take a budget hit of $178 million — an amount almost equal to its projected budget deficit — but will keep coverage going for most in the program. This commitment to kids' health reflects positively on Minnesota's political leaders.

Community health centers don't appear to have that state fallback.

Without an extension, Halvarson's organization will see a $2.5 million cut — about 60 percent of its total budget. "We're reaching the point where I have to be responsible as a businessperson to make sure we can cover our obligations," she said. That includes considering layoffs as well as reviewing leases and information-technology contracts, which may require 60- or 90-day notification periods for termination. Unless Congress acts soon, Halvarson will have to pull the trigger.

Halvarson made another key point: If the clinics close, many patients will get their care at emergency rooms or at clinics that don't operate on a sliding fee scale like hers. The result: uncompensated care for other medical centers.

State lawmakers ought to weigh what additional help can be provided to community clinics. The federal fumbling is unprecedented and unacceptable. Minnesota can and should do better.