WASHINGTON – U.S. Senator Bill Cassidy, M.D. (R-LA), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, delivered remarks during today’s hearing on community health centers (CHCs). He discussed the value of CHCs for rural and underserved communities, and stressed the importance of reauthorizing the Community Health Center Fund (CHCF) by September 30th. He also discussed the need for transparency with CHCF funding to ensure taxpayer dollars are used effectively and in a fiscally-responsible manner.
Click here to watch the hearing live.
Today we’re discussing an important piece of our health care infrastructure, community health centers. I’m a doctor. I’ve worked in Louisiana’s charity hospital system for over 25 years. I really appreciate the many community health centers providing primary care to low income and uninsured patients. They’re also providing behavioral health, dental services, and other care essential to the well-being of the community.
This is a topic which we can all agree upon. Frankly, that’s why it’s somewhat upsetting the majority chose not to work with Republicans in developing this hearing. There is no reason we could not have gone through the basic bipartisan Senate procedure to hold a bipartisan hearing. Republicans support this issue.
Calling partisan hearings is the prerogative of the Chair. But for issues like this, there’s no reason our staff should not be working together from square one.
I raise this because the Chair indicated at our last hearing that talks and hearings are not enough, and that we may use these talks in hearings as an avenue to produce serious legislation. I agree. But it is difficult to have a bipartisan legislative agenda if the hearings that serve as a prelude are partisan. We can have fruitful hearings and produce meaningful legislation when the minority is engaged and able to contribute, and the minority must be included in the planning of the hearing.
That said, we look forward to listening to the witnesses today and learning more about what we can do to address the needs of patients who depend upon community health centers.
In Louisiana, there are over 350 health center sites serving over 400,000 patients per year. Over a third of these health centers are in rural areas. Now rural communities tend to be older and at times have a greater disease burden, with fewer physicians and other health care personnel present. These factors make health centers’ work all the more important.
This Committee must reauthorize the Community Health Center Fund before September 30th. As ranking member, getting this and other reauthorizations done on time and in a fiscally-responsible manner is my priority.
To do this effectively, we need an understanding of the full picture. The landscape for community health centers has changed significantly since the Affordable Care Act was passed and the mandatory Community Health Center Fund was created. Ms. Farb from the Government Accountability Office will give us color on this from their most recent work from 2019. GAO’s report shows that health centers’ revenue more than doubled from 2010 through 2017. Further, GAO’s review raises the question of whether community health centers have become less dependent upon grants as revenue from Medicare, Medicaid, and private payors has increased.
This is not to say increased funding for health centers is not needed, that is something we will discuss today. But to underscore the fiscal climate we are in, Americans expect and deserve a full and thorough review of how their tax dollars are spent.
As Ms. Farb is aware, this week I requested that GAO update its work on sources of funding for community health centers. I ask unanimous consent to insert that request into the record (pause and thank the Chair).
As policymakers, this information is critical to make informed decisions. Especially when talking about mandatory spending. So I thank you Ms. Farb in advance for taking this project on.
Lastly, the Community Health Center Fund reauthorization needs to be paid for and Hyde protections need to be maintained.
As a physician, there is a saying, but also true of all society, “an ounce of prevention is worth a pound of cure.” If we improve health on the front end, we can avoid the costlier care on the back end.
The Chair has made similar points and we agree on that broadly.
However, we know that the Congressional Budget Office must operate within scorekeeping rules. More spending is more spending. There are a lot of figures that will be used today about health center savings to the overall health care system. I’ve seen $24 billion, $25 billion. Some of these statistics are based on data from 2006. It is interesting to think about how CBO could account for savings based on prevention, but they haven’t in the past and I don’t think any of us think that we can use this data from 2006 as a basis for picking amounts now towards reauthorization. Health centers do great work, but as we all know, in competing priorities, mandatory funding for health centers still needs to be paid for.
I thank our witness panel. I look forward to hearing how health centers are using investments from the federal government to provide essential care. And particularly as we sit down and understand this year’s reauthorization of the Community Health Center Fund.