According to their leaders, more than 1,500 medical centers funded by federal funds that offer services to millions of people with a low level of income, since partial closure of the government adds to other reductions of their income.
Some of these public medical centers may be forced to reduce medical and administrative personnel and even services. Some could even close. Their defenders warn that this can increase the pressure on the emergency departments of hospitals that are already saturated with patients.
“This is the worst time for all the years that I worked in medical care,” said Jim Mandjia, president and executive director Community of St. John Healthnet 28 clinics Which serves more than 144,000 patients in the districts of Los -Angeles, Riverside and San Bernardino, in California. “We are faced with federal contractions and extreme reductions at the state level that will affect services.”
Saint -Jones and other qualified medical centers at the federal level offer primary medical care and a wide range of other services without costs or prices adjusted to the income of each patient. At the national level, they serve nearby 34 million people In the most non -used areas of the country.
Federal funds come from two main sources, both are currently under pressure: subsidies provided partly through Public Health FundFederal and compensation for the help provided to patients using programs such as Medicaid, which offer a medical coating with low level or disability.
Joints of the joints of the States and the federal government jointly.
Recently, Congress has approved these funds with droplets. In March, legislators extended the subsidies until September 30. This money expired after the Congress controlled by the Republicans did not approve the law on financing, which caused a partial closure of the government.
Defenders of the centers emphasize that long -term financing is necessary in order to be able to plan with greater confidence, ideally with the help of many months.
Medical centers received subsidies for $ 4.4 billion. USA in early 2024. 5.8 billion dollars a year For two years to maintain fully operating centers.
The security network, representing medical centers, “is faced with several levels of problems,” said Vacheria Kis, vice -president of politics and regulatory bodies of the Association.
A New Law on State Expenses The fact that the Republicans call “one large act of a beautiful bill” will mean a significant reduction in Medicaid, which imposes another important threat to these centers.
En 2023, Medicaid 43% presented Of the 46.7 billion dollars. USA total income of medical centers.
Defensors warn that the reduced payments of Medicaid will aggravate the gap between available funding and operating expenses.
Financing is also necessary for personnel development programs to support the provision of medical services, since the centers are faced with difficulties in hiring and retaining employees, he said, he said. Feigel JacobsDirector of the Geiger Gibson program in the public health of the University of George Washington.
Los – The first centers From this type they opened in places such as Massachusetts in the 1960s. Historically, Congress financed them with the help of two -party support with some minor obstacles.
The current crisis began when the administration of Trump Frozen national assistance Through a memorandum released in January, which did not allow some centers to get already approved subsidies. As a result, some centers Closed or united In states such as Virginia.
The following contractions will also appear when patients face new requirements and problems. Among the changes in the Medicaid, included in the fiscal law and the legislation of President Donald Trump, there is a requirement that the beneficiaries have reported their working hours or other public events in order to be able to maintain their coating.
Meanwhile More generous subsidies The fact that the Biden and Congress administration approved to help consumers pay medical plans purchased in insurance markets in accordance with the Law on the low healthcare price (ACA) expires at the end of the year.
If the congress does not extend them, some consumer expenses will increase sharply.
One of the reasons for the closure of the government is that the Democrats want to expand these subsidies that protect consumers from increasing insurance costs. The bill on the financing of the Republicans did not include extension; Republican leaders in the Congress say that this issue should be discussed separately.
“Consumers will need more support than when liba,” said Jacobs, who warned that Medicaid contractions and the end of improved subsidies can “leave many people without covering.”
90% of patients from public medical centers have income from double the federal level of poverty Or less, and 40% – Latin AmericanField
“We get 300 calls for patients concerned with their coating,” said Mandjia from Saint -Jones.
Republicans do not attack the centers directly, although they supported the notches in Medicaid, which will affect their finances. Many argue that the costs of Medicaid volunteered and that a decrease in its growth will make the program more stable.
State and local support
Speaking for a more stable federal financing, centers are also looking for support for their local communities and governments.
Some states have already taken measures at the end of their annual budget. Connecticut, Minnesota, Illinois u Massachusetts They appointed funds to the centers. MarylandIN Oregon u Wisconsin They also offered support.
The question of the million is how long this money will last.
While some states increased their support to centers, others pass the opposite direction. Foresee the influence of abbreviations on Medicaid, states such as California Your own abbreviations In the program.
The Office of the Governor of California Gavin News, as well as the administration of federal resources and health services, did not respond to comments.
In Los -Angeles, Mandjia said that a possible decision was to work with allies at the district level, and indicated that there are about 10 million inhabitants in the Los -angles district.
“We can introduce a tax to increase financing of medical services,” he said.
The leaders of the centers form a coalition that “expects”, includes the main participants in the district healthcare system: public centers, clinics, hospitals, doctors, healthcare plans, trade unions. Purpose: to initiate a process to represent a civil initiative, which allows voters to decide whether they want to approve a tax intended for financing medical centers.
“We learn that the federal government and the state government are not reliable when it comes to guaranteeing continuous financing of medical services,” said Mandjia.
