Paying twice for local health centers

Posted: May 29, 2014

EVERY ONCE in a while you get a chance to meet two needs with one action.

I won't say kill two birds with one stone. This isn't about throwing stones or killing anything - just the opposite.

It's about changing public policy to enhance, maybe even to save, lives; and by doing so, possibly providing a political boost to a politician who could use one.

First, the policy: Community health centers for poor folks in Philly and across Pennsylvania are hurting.

They're losing money big time, according to a new study by George Washington University: $29 million in Pennsylvania this year, half or more of that in Philly.

Only five other states, none in the Northeast, are losing as much.

In fact, the vast majority, 71 percent, of centers and patients seeing losses are in 11 Southern states.

This could further justify our sometimes nickname: "Pennsyltucky."

We are one of 24 states opting out of provisions of Obamacare that expand aid to community health centers through Medicaid.

Maine is the only other northeastern state doing so.

This was done, ostensibly, to save tax dollars years from now. The feds pay the first three years and 90 percent of costs thereafter. But opponents, including Gov. Corbett, argue the future 10 percent share is unaffordable.

Thing is, Philly and Pennsylvania taxpayers now pay twice.

They pay to help fund centers in the 26 states accepting Medicaid expansion. They also pay for centers here since their care is mandated.

"The city pays," says Dr. Donald Schwarz, Philly health commissioner. "We are very much the provider of last resort."

When I ask if this means taxpayers pay twice, Schwarz says, "That is correct."

Philadelphia has dozens of centers, some private, some nonprofit, eight run by the city.

Schwarz estimates they serve 30,000 people, mostly working poor. He says the state's decision is costing Philly $15 million to $20 million per year.

Statewide, there are roughly 200 centers experiencing upticks in service and loss of federal dollars (an estimated $43 million over three years), says Jim Willshier, policy director for the Pennsylvania Association of Community Health Centers.

Peter Shin, lead author of the GW study and associate professor at GW's Milken Institute School of Public Health, says centers are hurt several ways.

Shin says centers don't have needed resources, can't hire needed health-care professionals and, since some expanded in anticipation of more federal funds, "maybe some will have to close."

This is but a piece of the impact of the state not accepting Medicaid expansion.

(The overall loss in Pennsylvania is estimated at $500 million this year to provide care for 500,000 people and create up to 35,000 health-care-related jobs.)

But it's a piece that should serve as a mirror for state leaders.

They should look into it and ask these questions:

How does denying providers of last resort access to money for citizens in need reflect upon my leadership and my state?

How does a policy that fails to meet immediate needs, costs taxpayers twice and puts community centers at risk reflect responsible governance?

Corbett, seeking re-election from a deep political hole, already reversed himself on privatizing the lottery, fighting for voter ID, total opposition to medical marijuana and legal defense of a same-sex marriage ban.

It's time for another reversal.

Accepting new Medicaid funding makes fiscal sense. The state budget due next month faces an estimated $1 billion deficit.

It makes political sense. Democrats use Medicaid to hammer Corbett. Why not take away one of their tools?

It makes image sense. Our governor, sometimes called "Tom Corporate," implemented $1.2 billion in business tax cuts while simultaneously cutting education and refusing federal health-care help. An image tweak could prove useful.

So here's a chance to meet two needs with one action, even if that action is limited to health centers.

A change can mean healthier Pennsylvania communities and a healthier political profile for Corbett. And, it's the right thing to do.




comments powered by Disqus