A third of Americans lack primary care

Report: Community health centers can help fill the coverage gap but they desperately need funding

Nearly a third of Americans lack access to primary care, according to a new report.

More than 100 million people in the United States don’t have a primary care provider, and about a quarter of those are children, according to the report, “Closing the Primary Care Gap,” released Monday by the National Association of Community Health Centers.

Primary care is important for patients’ day-to-day needs for good health, and it helps manage and prevent chronic illnesses and identify risk factors for serious conditions.

The association refers to “medically disenfranchised” people as those without primary care and who aren’t patients of federally funded clinics, also called low-income or community health centers. The states with the highest percentage of medically disenfranchised residents are New Mexico, Mississippi, Delaware, Alabama and Montana. The five with the most disenfranchised residents are Florida, Texas, California, North Carolina and Georgia.

The association says rural hospital closures and a nationwide shortage of primary care providers are driving the crisis.

Primary care providers as well as specialists are more concentrated in highly population urban areas that have more insured and higher-income residents, leading to “unequal distribution” of clinics and providers. Medically underserved communities often lack transportation, insurance, finances and have other barriers to health care.

The Senate Committee on Health, Education, Labor and Pensions is holding a hearing Thursday on community health centers and health care deserts.

NACHC says its report sheds urgency on supporting community health centers that can fill these gaps in care.

“With sufficient resources, the health center program can expand into more underserved communities and continue to close the gap in primary care for America’s medically disenfranchised population,” the report said.

But three-quarters of health centers reported gaps in funding for planned improvements, according a 2020 report from the association.

Community health centers offer care to members of underserved communities who often lack a “medical home.” About half are people of color, and the majority of patients live below poverty.

The number of patients at community health centers grew about 25% from 2015 to 2021.