Funding for U.S. health programs for poor up in air
Ruth Spalding is a social worker and therapist who spends her days trying to help poor people whose lives are often something between terrible and worse.
“I treat a lot of depression, anxiety, PTSD (post-traumatic stress disorder),” she told me recently. “Most of my patients are highly traumatized. I have folks on my caseload with severe and persistent mental illness, folks who experience paranoid delusions. I see a lot of survivors of domestic violence.” But that’s not what is now causing her stress. Spalding, 30, grew up in a single-parent home in Ann Arbor, Mich., with a mom who went deeply in debt so she could live where her daughter could attend a good high school. Today, after earning a graduate degree at the University of Michigan, she works for Mid-Michigan Health Services in Houghton Lake.
“I love my job so much,” Spalding said, because she is helping people who otherwise would get no help at all.
But funding for the network of Federally Qualified Health Centers is now threatened, as is that for the better known Child Health Insurance Program, or CHIP, which insures nine million poor children. Both have been automatically renewed for years.
Yet that hasn’t happened. Neither was a priority for the Trump administration.
The two programs’ funding got bogged down in squabbles over other issues. Government authorization for both CHIP and the network that employs Spalding, the Federally Qualified Health Centers Program, expired Oct. 1, the day the national news was dominated by the mass murder of 58 people in Las Vegas.
While their struggles have been largely under the radar, if both programs were to vanish, it would have enormous and disastrous consequences for millions of Americans.
Recently, the failure to renew annual funding for the Children’s Health Program has received press attention.
U.S. Rep. Dale Kildee (D -Flint) has been especially vocal about the need for the program, which covers an estimated 116,000 children in Michigan alone, kids he said “will lose access to basic health care, including doctor checkups, immunizations and critical preventive care,” if CHIP ends.
This is especially crucial for Flint, because of the need to monitor children exposed to high levels of lead — and because authorities got special permission to use CHIP funding to help remove lead from homes and pipes.
Congress did, after a blizzard of unfavourable publicity, pass a short-term bill right before the Christmas break that included US$2.85 billion to fund CHIP through the end of March. However, what’s needed is a permanent piece of legislation to do that through the end of the year.
Funding for the sprawling network of Federally Qualified Health Centers is even more at risk. Last year, they served more than 680,000 Michigan residents in hundreds of underserved areas. Most are rural, but a few are in urban areas where few doctors want to go.
Their plight is complicated, Spalding said, because many patients and even some who work in centres like hers aren’t even aware they are dependent on federal funding.
Unlike the CHIP program, Federally Qualified Health Centers have existed since 1944.
If the program doesn’t get funded, “those people will still get very sick. They will go to the ER (emergency room) instead. They will still rack up bills and debt. People will die over this,” Spalding said.
“People will get bankrupted and live in squalor over this,” she said, pausing to note she wasn’t speaking for the system or her employer, Mid-Michigan Health Services.
Mid-Michigan Health Services is, like many community health centres, a full-service medical provider that last year served about 16,000 patients.
“The brilliant thing is that we were created to serve the poor and we can’t turn anyone away due to inability to pay,” Spalding said. “We have decided as a society just to throw away large portions of our nation, to write them off and provide them substandard education, wages, housing.”
And if funding doesn’t come through for the health centres, she said, “they won’t even have that.”