Local community health centers have so far expanded as the 2010 federal health care reform law intended, administrators and industry experts say, bringing more services and better facilities to low-income residents.
As stipulated in the 2010 Affordable Care Act, Congress in 2011 began a five-year, $11 billion plan to expand the federal community health center program so it could handle the health reform law's proposed increase in private and Medicaid-insured Americans in 2014.
The three centers in Calhoun, Cleburne and Talladega counties are expanding primary-care services, operating hours and facilities for thousands of area residents as expected and should be ready for any influx of additional patients next year, despite recent federal budget cuts and proposed changes to the state's Medicaid system, administrators and health experts say.
According to the National Association of Community Health Centers, such centers serve the primary health care needs of more than 22 million patients in more than 9,000 locations across the United States. The centers provide care to patients, regardless of their ability to pay.
Wayne Rowe, CEO of Gadsden-based nonprofit Quality of Life Health Services, which owns the Anniston Quality Health Care, Cleburne Quality Health Care and Talladega Quality Health Care community health centers, said the facilities are expanding or improving in various ways through the Affordable Care Act funding.
"Yes, they are progressing pretty well," Rowe said.
Rowe said Quality of Life has purchased a larger facility in Cleburne that will soon house the health center there once it has been renovated.
"And we will be adding a pharmacy, dental and behavioral health services there," Rowe said.
Rowe said the Talladega facility is undergoing renovations. Meanwhile, operating hours at the Anniston center were expanded to handle the workload there. Rowe added that more personnel will be hired for the three centers.
"We will be hiring two more physicians and one more nurse practitioner for these three sites," Rowe said.
To Jim Carnes, spokesman for Alabama Arise, a non-partisan group that advocates for low-income residents of the state, the importance of community health centers in the state cannot be overstated.
"They are a crucial part of the health care system and they provide essential primary care to thousands in Alabama," Carnes said.
Don Williamson, state health officer, agreed that community health centers are an important part of Alabama's health care system.
"They provide important services to low-income people and they are a critical linchpin for communities," Williamson said.
Rowe said the Anniston center serves around 30,000 residents a year, while the Talladega center serves about 11,000 and the Cleburne facility serves approximately 20,000 residents annually.
Medicaid accounts for nearly 40 percent of all health center revenues throughout the country. For Quality of Life, 30 percent of its revenue comes directly from federal funding while the rest comes from Medicaid, Medicare and private insurance, Rowe said.
According to Healthcare.gov, due to their assistance with low-income, uninsured Americans, community health centers are an essential part of the Affordable Care Act. In 2014, the law will expand Medicaid coverage for millions of Americans and provide cheaper insurance for millions more through insurance exchanges — placing much of the responsibility of treating those new patients on community health centers.
"The total number of health center patients is expected to increase," said Rachel Arguello, policy analyst for the Kaiser Family Foundation, a nonprofit group that focuses on health care issues facing the country. "So much of the money will be used to hire more people and increase services."
Amy Simmons, director of communications for the Association of Community Health Centers, said that by the end of 2013, $5.2 billion of the planned $11 billion expansion funding will have been spent.
"The great news is the law has allowed more health centers where people live and work and expanded their reach to patients," Simmons said.
However, some recent federal budget cuts, including $600 million in 2011 for health centers, has slowed the growth of facilities across the country, Simmons said.
"They've had to expand more slowly due to cuts to discretionary funding," Simmons said. "That has certainly staved off health care center expansion."
Rowe said, however, that budget cuts have not slowed the expansion efforts of the local centers — not even the sequestration cuts that took effect March 1. At least, not so far.
"I think right now we'll be okay up until the end of September," Rowe said, referring to the end of the fiscal year. "After that I don't know what will happen."
The Kaiser Family Foundation stated in a March report that diminishing federal funding will pose a problem for health centers in the coming years. The report also states some health centers will face a potential challenge next year if they operate in states that opt out of the Affordable Care Act's Medicaid expansion. Those centers will face a higher rate of uninsured patients.
Gov. Robert Bentley has said he will not agree to expand Medicaid in Alabama until structural reform of the program is addressed.
The Kaiser Family Foundation report states, "a state decision not to expand Medicaid would likely depress health center growth because health centers would have to divert growth funds to finance care for uninsured patients who were expected to gain Medicaid coverage."
In lieu of expanding Medicaid, the state Legislature is considering a bill that proposes to turn over control of the delivery of care through Medicaid to for-profit companies by 2017.
"You are reorganizing the existing delivery system," said Williamson, who supports the change. "You make it easier for Medicaid to take care of more people."
Williamson said the changes should not be a hindrance to health centers in the state.
"My assumption is they would participate in the network much the way any private physician would," Williamson said.
Rowe also said he did not think the lack of Medicaid expansion in the state would negatively impact the local health centers and the residents they serve.
"We'll still get Medicaid dollars and they (residents) will still have access to being insured," Rowe said.
Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.