As Medicaid shrinks, clinics for the poor struggle to survive
These health centers have each seen a loss of at least $500,000 in revenue as a result of the Medicaid phaseout, according to Amy Simmons Farber, a spokeswoman for the health center association.
By the end of December, Family Health Centers, a network of clinics in Louisville, Kentucky, had lost more than 2,000 Medicaid patients since the policy change took effect in April, a drop of nearly 6 percent, said Melissa Mather, a spokeswoman for the clinic. For every one percent decrease in Medicaid patient visits, she said, the clinic experiences a drop in revenue of $175,000 to $200,000.
Bethesda is now engaged in a “monthly survival game,” said Bethesda operations manager Amber Greene, who also works as a nurse. Standing in a supply closet to make her point, she gestured to a modest supply of Tylenol, Motrin and thermometers donated by the church next door.
The clinic, whose vast majority of patients are on Medicaid, needs roughly $115,000 each month to run its medical and dental clinics, but still has a monthly deficit of about $10,000. Sometimes the costs are small, such as the reimbursement for the injection that Dr. Price administered to the mother who could not pay. But they add up, forcing the clinic to be creative to preserve funds. A local pharmacy offers antibiotics at a significant discount, and the clinic has lowered the cost of the virus tests by performing them in-house.
Texas health officials have defended the settlement as a natural return to Medicaid’s intended shape and size. Conservative health policy experts have also argued that reducing the roles is important to support the program financially.
“The reality is that many health care providers cannot sustainably treat Medicaid patients because the program provides so little reimbursement and the claims process is so excruciating that many providers ultimately suffer losses to the point of closure,” said Tanner Aliff, an expert in the field of health policy. at the conservative Texas Public Policy Foundation.