Lynne Weidel has options, but they’re all painful.
The executive director of Cheyenne Health and Wellness Center expects to lose thousands in federal grant funding because of automatic federal budget cuts known as sequestration. To absorb the impact, her center has two basic choices: cut back on hours or cut back on staff.
Either one will reduce services for poor and uninsured patients who rely on the center, Weidel said. There are scant other places for them to receive affordable medical care.
“People fall between the cracks,” she said. “There is just no question about it. When there is a hole in the safety net, people will fall through that hole.”
The Cheyenne clinic is one of the nation’s 1,200 federally funded community health centers. The centers offer services on a sliding payment scale, making them one of the few options in Wyoming for the uninsured to receive basic medical care outside of a hospital emergency room.
Many federally supported health programs avoided the fiscal pain caused when Congress couldn’t reach a compromise to reduce the federal deficit prior to March 1. The nation’s health centers weren’t so lucky. The cuts are expected to cost them a combined $120 million in grant funding, according to a report released last week by the George Washington University School of Public Health and Health Services.
Sequestration could result in about 900,000 patients losing access to services through health centers. Some of the country’s most vulnerable groups – the poor, children and people with chronic diseases – would be among the hardest hit.
The report predicts none of the country’s federally funded health centers will be spared the effects of sequestration. The impact will be concentrated over the second half of the fiscal year, forcing health centers to make deeper cuts to absorb the loss in funding.
“Sequestration will significantly impact health care performance just as the national emphasis moves toward strengthening
primary care,” the report concludes.
Health centers often charge for services based on what a patient can afford. A patient might pay $30 for a visit that costs the center about six times that amount.
The Cheyenne center uses federal grant funding to help make up the difference, said Weidel. She’s now expecting to lose $38,000 of that funding during the remainder of the federal fiscal year.
Clinic officials are still deciding how they’d deal with such a loss. But the results will ultimately be the same.
“It all comes down to cuts in service,” Weidel said.
Up the road in Casper, officials at the Community Health Center of Central Wyoming haven’t yet learned what impact sequestration cuts might have on funding, said Chief Executive Officer Marty Thone.
About a quarter of the center’s funding comes from the federal government. If a significant portion goes away, the clinic would have to consider cuts, Thone said.
“We would have to evaluate those and determine what we have to provide and what do we want to provide,” he said.
Reducing service could increase the burden on hospital emergency departments to care for people without health insurance. But emergency rooms are a costly and ineffective way to deal with basic medical issues, Thone said. If someone cannot pay, hospitals must write off costs or pass them on to customers who can pay.
In the absence of basic medical care, chronic diseases can develop into serious problems before they’re finally treated, said Wyoming Medical Center Chief Financial Officer Don Claunch. For example, if diabetes isn’t properly managed, patients can end up with heart problems or infected limbs.
The sequestration cuts were designed to force Congress and the White House to find an effective way to reduce the federal deficit. The fact that leaders couldn’t reach a decision troubles Weidel. She acknowledges the need to rein in spending, but said it’s difficult to understand why political leaders couldn’t resolve the situation.
“It’s just very frustrating that we cannot achieve consensus on a federal level,” she said. “Having to be consistently confronted with these types of decisions is very discouraging.”