A Downward Slope
"Having prepared for a decade of strong growth, health centers now face significantly diminished funding and the prospect of a slower expansion of Medicaid, both of which exert downward pressure on health center expansion," the Kaiser Commission on Medicaid and the Uninsured stated in March.
"In light of health centers' role in our healthcare system and their unique potential to advance the goal of expanded access to care for the medically underserved, these shifts in the direction of retrenchment pose a challenge going forward." Wiltz says he is experiencing the effects of that retrenchment.
"We got money to do the capital development at almost all centers in the U.S. Before that we were in two double-wide trailers and an old house. A lot of centers were in churches and schools and had not gotten any money from capital development to even get out of those dilapidated buildings into more modern facilities," Wiltz says.
"We built these facilities with the thought that these uninsured would be covered through Medicaid expansion. That was the model that we have been operating on. I have two buildings that have been renovated and are ready to go but I can't open them because if I do and 80% who come to us are uninsured, I don't have operational dollars."