September 21, 2020, 12:44 pm News Staff -- This pandemic year is no time to let funding lapse for a number of vital health programs, the Academy and 16 other medical and health organizations told congressional leaders this month.
Yet disruption looms for the Teaching Health Center Graduate Medical Education program and the Community Health Center Fund, among other federal "health extenders," with temporary funding set to expire Nov. 30.
These, along with the Special Diabetes Program and Special Diabetes Program for Indians, the National Health Service Corps and the Personal Responsibility Education Program, are "bipartisan, essential and life-saving programs," said the Sept. 11 letter. Allowing them to drift this fall would compromise patient access to vital public health services, interrupt medical research and jeopardize essential medical training and health care personnel placement.
Particularly given that the scheduled funding termination would occur while COVID-19 continues its assault on U.S. health, the groups warned, "it is essential that Congress approve a five-year reauthorization of these key programs and consider proposed increases."
The letter was sent to Senate Majority Leader Mitch McConnell, R-Ky.; Senate Minority Leader Chuck Schumer, D-N.Y.; House Speaker Nancy Pelosi, D-Calif.; and House Minority Leader Kevin McCarthy, R-Calif.
"The THCGME program is, without question, one of the most successful, efficiently run programs in the country," the Academy told the same lawmakers a year ago, when time was running out on previous temporary funding for the extenders. "It is a mission-focused program that has a proven track record of achieving its legislative mandate of training the next generation of primary care physicians. Since its inception, this program has successfully trained over 1,000 primary care physicians and dentists who, in return, have established practices and provided high-quality care to millions of Americans."
Since September 2019, these programs have endured four short-term extensions, and the AAFP has continued to campaign for funding stability. The most recent such reprieve -- the one ending in two months -- was bundled into the Coronavirus Aid, Relief and Economic Security Act. The Academy has emphasized that THCGME funding must be part of any further pandemic relief legislation.
The Sept. 11 letter adds an urgent reminder that the fall residency recruiting season is underway, with teaching health centers still unsure of how many medical students to attract and prospective residents unable to feel confident in selecting THCs.
"This means that some of the best-suited future medical residents will not train in a community setting due to the failure of Congress to enact meaningful, long-lasting reauthorization legislation," the groups said.
The letter stressed that the full suite of health extender programs is crucial in the fight against COVID-19, especially as data continue to verify the pandemic's disproportionate impact on minority patients and risk to people with chronic conditions.
"As a result of short-term extensions and the undue strains they place on long-term budgeting and planning, these programs and the communities they serve have experienced cuts to essential public health services for medically underserved patients and cuts to type 2 diabetes prevention, treatment and management services for American Indians and Alaska Natives," the letter said. It added that people with type 1 diabetes are "3.5 times more likely to die in the hospital from COVID-19 than those without diabetes."
The Academy and its co-signatories also told lawmakers that, despite the turmoil caused by the lack of long-term funding security, community health centers have delivered primary care and preventive services to some 30 million patients across 12,000 rural, urban and frontier communities.
"With millions of people newly unemployed and without private health care coverage in the wake of COVID-19's economic toll, and as state and local funds for social safety net programs continue to dwindle, the role health centers play in providing care to Americans in need will only continue to grow," the groups cautioned.
Among the Academy's co-signatories were the American Association of Teaching Health Centers, the American College of Obstetricians and Gynecologists and the Council of Academic Family Medicine.