Community health

June 24, 2005

OVER THE past four years, the Bush administration has steadily increased funding for community-based health centers that provide care to uninsured families, homeless people and the working poor, among others. Congress has generally supported President Bush's funding recommendations, but this month, House lawmakers slashed his 2006 proposal, putting in doubt a worthy goal to increase the number of people served by these centers to 16 million next year.

A House appropriations subcommittee approved just $100 million in new financing for the centers, far short of the $304 million proposed by Mr. Bush for the 2006 fiscal year and significantly less than what is needed to keep poor and uninsured people from relying on hospital emergency rooms for primary care. Senate lawmakers can help avoid this more expensive option by fully funding the president's proposal.

House lawmakers' shortsighted attempt at saving money would mean less medical care for the people who need it most at a time when health care costs are rapidly rising and millions of Americans have no health insurance.

More than half of the 12.3 million people who used these centers in 2003 had incomes at or below the federal poverty line of $15,260 annually for a family of three; 39 percent had no health insurance; 44 percent lived in homeless shelters, and almost 11 percent lived on the streets.

In Maryland, which has just 12 centers, 62 percent of patients lived below the poverty line last year and just under 29 percent were uninsured. Almost 14 percent were under age 5, and 17 percent were 5 to 12 years old.

Health Care for the Homeless, a Baltimore center that sees 5,000 people annually and the only one of the federally funded state centers that serves homeless people exclusively, recently received a $233,000 federal grant to provide additional health care. As a result, 1,000 new homeless patients will get access to primary care, mental health care and addiction treatment. More staff will be hired and a new Saturday clinic will serve homeless women in the mornings and day laborers in the afternoons.

If one agency can do so much with six figures, imagine what can be done around the country with $304 million. Fewer people using emergency rooms as doctors' offices would save governments and taxpayers millions of dollars and keep medical resources for true emergencies.

The number of people served at community heath centers grew from 10 million in 2001 to 13 million by 2004 because the Bush administration put more money into them. The proposed increase would support 1,200 new or expanded centers nationwide, including 40 in high-poverty counties.

The House committee's recommendation represents only a 1 percent increase in funds, the smallest increase in nearly a decade. It would shut out 2 million people.

House lawmakers should restore the money.

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