Obamacare repeal worries community health centers

Such centers, set up to care for underserved populations, have benefited not only from an increase in funding authorized by the Affordable Care Act, but also from a provision of the law that allowed states to expand Medicaid to more low-income people.

"People are nervous, obviously," said Randy Runyon, president and chief executive of the Ohio Association of Community Health Centers. "There are a lot of things the Affordable Care Act provided. Medicaid expansion is the tip of the iceberg, really."

Before the law took effect, 34 percent of health center clients were uninsured; in 2015, that dropped to 16 percent. Among homeless clients, the uninsured rate dropped from nearly 80 percent to less than 25 percent.

Among other changes, more centers have expanded to treat people addicted to heroin and other opiates, Runyon said. Fewer than five centers in Ohio did that work in the past. Now, about 40 offer such treatment.

Overall, community health centers have expanded from about 200 to 275, adding services in about two dozen counties statewide. The centers served 623,000 patients in 2015, about 50,000 more than the year before.

Columbus City Council President Zach Klein is among elected officials who have expressed concern about the future of community health centers in the face of an Affordable Care Act repeal.

"Their need always is growing," Klein said. "When you start taking Medicaid expansion away, that's going to continue to drive up the demand for basic services to them, which puts more burden on them to provide the quality of care that's necessary in our community."

Community health centers and other issues will be the topic of community forum Thursday night from 6 to 7:30 p.m. at the North Broadway United Methodist Church, 48 E. North Broadway on the North Side.

Health centers in central Ohio include Primary One Health, Southeast Inc., Lower Lights Christian Health Center and Heart of Ohio Family Health.

At Southeast, Medicaid expansion has allowed more patients to be seen by primary caregivers, dental care has been added and medication-assisted treatment has been offered to more people addicted to heroin and other opiates, said Sandra Stephenson, director of integrated health care.

"We have many clients and patients who are pretty anxious about what's going to happen, because for the first time in their adult lives they've had access to health care," she said. "They wonder what they will do if they lose coverage.

"Rapid upheaval or change is never helpful in most processes, so what is needed is solid information and the ability for providers to know the roads we're going down so we can protect the people we serve."

Klein said the city needs to determine what can be done from policy, budgeting and advocacy perspectives to ensure quality health care continues to be provided.

"Those that have the least are going to suffer the most, and that's not who we are as a society — that's not who we are as a city," he said. "That's why I think it's important to highlight that this isn't just a political slogan — repeal and replace. This has real world implications."