If President Donald Trump鈥檚 massive budget bill passes, it could mean cuts to Medicaid and the loss of health insurance for . More than half of the patients at and other community health centers are Medicaid recipients.
Community health centers serve all patients regardless of their ability to pay, meaning they rely heavily on funding sources other than private insurance.
Dr. Kendra Holmes, president and CEO of Affinia Healthcare, said her primary concern with a loss of Medicaid coverage is the health of the patients.
鈥淲hen we see that individuals lose coverage, they don鈥檛 seek care,鈥� Holmes said. 鈥淭hat鈥檚 going to be a decrease in medical visits, a decrease in behavioral health visits and an overall decrease in the overall health of Missouri.鈥�
This can be especially concerning in rural areas, where access to healthcare is already limited. The Senate version of Trump鈥檚 so-called 鈥淏ig Beautiful Bill鈥� was modified to include a $50 billion rural hospitals fund to attempt to mitigate the damage.
The Senate passed the budgetary package on Tuesday, and the House moved forward Wednesday with a key procedural vote despite some disagreement among the GOP.
If passed as is, the bill would cap provider taxes that help pay for state Medicaid funding at 3.5%. Missouri鈥檚 Federal Reimbursement Allowance currently allows the state to tax hospitals and other medical providers at 4.2%.
During a visit to Affinia鈥檚 clinic in north St. Louis, State Senator Steven Roberts, D-St. Louis, said the program brings in over $4 billion annually to state Medicaid.
鈥淲ithout the FRA, Missourians face a $1.5 billion budget hole,鈥� Roberts said. 鈥淥ne that would have to be filled by either cutting vital services or raising taxes.鈥�
Another change in the bill would institute work requirements for Medicaid recipients of 80 hours per month for able-bodied adults under 65 who don't have dependents.
Holmes said she is concerned that the state will not have the capacity to process all of the paperwork required to verify patients鈥� work status and hours, so even people who do meet the work requirements may not be able to receive care.
鈥淭he state is not going to be able to keep up,鈥� Holmes said. 鈥淎nd therefore we have people who are eligible, who are working individuals taking care of their families, who are going to lose Medicaid coverage not because they鈥檙e not eligible, but because of red tape.鈥�
Even without changes to Medicaid, Affinia is already seeing cuts in the federal funding that helps it continue operating. Holmes said the health center recently had some of its immigrant and refugee funding cut, as well as grants for providing vaccines. A decrease in Medicaid would likely result in a decrease in patients, further straining Affinia鈥檚 budget.
Holmes said the health center continues to rely heavily on grants, and does accept patients with private health insurance alongside Medicaid recipients and uninsured patients.
For Abbi Piper, a dental hygienist at Affinia, her stance on the issue is clear.
鈥淲e cannot cheat these people. They need help, they need their insurance,鈥� Piper said. 鈥淲e need Medicaid now.鈥�
