The Trump administration announced that the federal Department of Health and Human Services (HHS), will prohibit health services that are funded by taxpayers for undocumented immigrants, which includes “community health programs.”
The measure could negatively impact the health service provided by more than 600 community health centers to people without health insurance or with Medicaid in North Carolina.
What HHS argues
The agency said, which will rescind the 1998 interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), which extended certain federal public benefits to individuals without legal status in the country.
“For too long, the government has diverted tax dollars from working Americans to incentivize illegal immigration,” HHS Secretary Robert F. Kennedy, Jr. said in a statement.
“Today’s action (Thursday, July 10) changes that: it restores the integrity of federal social programs, enforces the rule of law, and protects vital resources for the American people,” the secretary added.
PRWORA, known as welfare reform, was passed during the Clinton administration and gave states greater autonomy to administer welfare programs.
They analyze the impact state
To understand how undocumented immigrants would be impacted in accessing these health services in community centers, Enlace Latino NC spoke with the North Carolina Community Health Centers Association (NCCHCA).
“The NCCHCA is currently working with national partners and legal experts to review and understand the federal administration’s announcement regarding its interpretation of the Personal Responsibility and Work Opportunity Act of 1996,” NCCHCA spokesperson Brendan Riley told us.
Riley noted that while the notice is effective immediately,Health centers both in North Carolina and nationwide are waiting for additional guidance to understand what this means for their services and their patients.
In this regard, Riley cited a declaration of the National Association of Community Health Centers (NACHC).
More than 600 health centers around the state would be impacted
North Carolina is home to 43 Federally Qualified Health Center (FQHC) organizations, and similar organizations operating more than 600 individual health centers.
“More than 380 of them are traditional clinics, more than 250 are school-based health centers, and more than 60 are mobile units,” Riley said.
So far, Community Health Centers provide medical care and dental primary care, in 92 counties to more than 762,000 patients, regardless of their ability to pay.
They will try to continue providing services
Riley said that, given the looming crisis and while they analyze the full extent of the impact on health centers and their patients, they will continue to provide services.
“Community Health Centers will do everything possible to ensure that North Carolinians can continue to access comprehensive, cost-effective, and lifesaving primary care services, regardless of ability to pay,” the spokesperson said.
According to Riley, Community Health Centers are required by their mission and by federal statute to serve the community without regard to ability to pay, including insurance status.
“Health centers remain committed to their mission. Health centers will never turn away a patient due to inability to pay or the status of their coverage. But whether health centers can continue to keep their doors open in the coming years is another matter,” he emphasized.
Big losses from Medicaid cuts
The NCCHCA indicated, in a release June 17, that a new study found that these health centers in the state would face cuts of more than 70% of their annual Medicaid reimbursements (more than $100 million per year) with the mandate of work requirements of the approved “Great Beautiful Law” of Trump.
"With reduced Medicaid reimbursement revenue and rising uncompensated care costs, the health center network will be overwhelmed," he explained.
National researchers at NACHC estimate that the Trump administration's new law's reductions in health insurance coverage among health center patients could reduce capacity by 30% nationwide.
"This means fewer providers, longer wait times, and the potential for entire communities to lose access to care when they need it," the spokesperson warned.
You may be interested in: Citizen children are excluded from the Child Tax Credit if their parents are undocumented.
How the closure of health centers could be avoided
According to Riley, to prevent clinic closures in the coming years, lawmakers can take steps now to preserve the ability to provide cost-effective primary care to the more than 762,000 patients they currently serve.
“By the end of September, Congress must not only extend federal funding for the expiring Health Centers program, but also increase this investment after years of stagnant funding extensions that have failed to keep pace with the rising cost of care,” he noted.
The government would also have to restore access to critical resources that health centers relied on for years through the drug discount program, until drug manufacturers abruptly began imposing restrictions a few years ago.
"These restrictions have not only reduced the financial resources that health centers rely on to maintain their services and workforce, but patients have also faced higher medication costs as a result," the spokesperson noted.
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