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How a government shutdown would affect community health centers


The people who run and use community health centers across the country are among those anxiously watching Congress this week. The clinics rely on federal funding that will expire on Saturday if lawmakers can't reach a compromise and the government shuts down. Sarah Boden with WESA in Pittsburgh explains how the standoff could disrupt health care for millions of low-income Americans.

SARAH BODEN, BYLINE: Northview Heights is an isolated neighborhood on the edge of Pittsburgh. The majority Black community doesn't have a grocery store or a library or even a post office, but it does have a doctor's office.

DALLAS MALZI: So we gave him all of his 4 year vaccines, which should mean that he's good to go.

BODEN: Dr. Dallas Malzi is a pediatrician at North Side Christian Health Center. It's known as a federally qualified health center, and there are nearly 1,400 across the country. They deliver care on a sliding scale and are mandated to serve everyone, regardless of a patient's ability to pay or immigration status.

MALZI: I want you to take a big, deep breath, OK?

BODEN: While Malzi listens to the boy's lungs, Leslie Hawthorne works across the hall. She's spent all afternoon trying to find help for a patient who's recently become homeless and is living in a broken RV.

LESLIE HAWTHORNE: This is a really complex case because she also has high-risk medical diagnoses, and that's the kind of patient we see a lot of.

BODEN: Community health centers like North Side Christian are located in low income and rural communities. Without federal grants, many would not survive. In the modern era, a federal government shutdown hasn't lasted longer than 34 days, so they hope their funding will be restored eventually. But not knowing is disruptive and leads to missed care. During previous funding crises, these clinics made tough choices. Melinda K. Abrams is with the Commonwealth Fund.

MELINDA K ABRAMS: Community health centers institute hiring freezes. They reduce staff hours or lay off staff or they reduce the hours of operation.

BODEN: And right now, it's a bad time for clinics. High inflation means they're paying more for medical supplies and having trouble with staff turnover. And then there's Medicaid. It's these clinics' biggest source of revenue. But when COVID policies changed, millions of people suddenly lost their Medicaid coverage. Now community health centers are scrambling to get patients re-enrolled. Back at North Side Christian, I chat with Lenee Hayward after her son's checkup. She tells me, before coming to this clinic, she had to take two buses to get to the pediatrician.

LENEE HAYWARD: Don't take it away (laughter). We need it. It's very convenient for everybody. Don't take it away.

BODEN: North Side Christian says if their finances get any worse, they may have to cut their hours or could stop offering dental services and mental health care. For NPR News, I'm Sarah Boden in Pittsburgh.

MARTIN: This story comes from NPR's partnership with WESA and KFF Health News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sarah Boden covers health, science and technology for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio where she covered a range of issues, including the 2016 Iowa Caucuses.

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