GLENWOOD SPRINGS, Colo. – El Congreso debe tomar acción antes del primero de octubre para frenar un recorte del 70 por ciento de fondos federales para la red nacional de unos 1,400 centros de salud que atienden a casi 27 millones de pacientes.

Un ajuste propuesto a la crisis de presupuesto fue introducido ante la Cámara de Representantes (House of Representatives), y dos miembros de la delegación de Colorado dicen que respaldarán la medida.

Mientras el Senado se apura para rechazar y sustituir la Ley de Cuidado Asequible (Affordable Care Act) antes del 30 de septiembre, hay otra fecha límite para la salud que está recibiendo mucho menos atención.

Si el Congreso de los Estados Unidos (US House) no recupera antes del 1º de octubre los fondos para el Programa de Centros de Salud (Health Centers Program), de los que dependen 1,400 centros de salud que atienden a 27 millones de pacientes en todo el país, el programa podría perder 70 por ciento de sus fondos federales.

Ross Brooks, Presidente de Consejo (CEO) de los Centros Mountain de Salud Familiar (Mountain Family Health Centers), anticipa las posibles consecuencias negativas.

“Hay unos 62,000 pacientes que reciben atención a través de centros comunitarios de salud en Colorado, que están en riesgo de perder este servicio. En mi centro comunitario de salud de “Western Colorado” hay unos 6,000 pacientes que podrían perderlo.”

La Ley de Inversión para la Modernización y Excelencia de la Salud Comunitaria (Community Health Investment Modernization, and Excellence Act, CHIME) HR 3770 fue llevada a la Cámara. Brooks dice que su aprobación proveería un nivel de fondos este año y garantizaría un flujo sólido de recursos para los próximos cinco años. La iniciativa tiene actualmente 13 copatrocinadores, y dos miembros de la delegación de Colorado han dicho que se unirán oficialmente al esfuerzo pasado el receso.

El Programa de Seguro de Salud Infantil (Child Health Insurance Program), que atiende a unos 9 millones de niños a nivel nacional, también expira el primero de octubre. La semana pasada, miembros del Comité Senatorial de Finanzas acordaron en principio extender el programa CHIP otros cinco años. Brooks dice que, si el GOP tiene éxito rechazando la ampliación de Medicaid, y si el CHIP no es fondeado, casi 600 mil coloradeños perderán su cobertura.

“Tendrás impactos negativos significantes con la reducción, en los que la única elección para la gente será usar la sala de emergencias en el hospital. Y eso no sólo es malo para nuestra salud individual, sino también tendrá impactos muy negativos en el costo total de los cuidados.”

Brooks agrega que la incertidumbre en torno a esos fondos ya está causando problemas para reclutar y retener al personal, mantener el flujo de caja, y dice que también pone una pausa en ciertas compras de equipo y en proyectos imperativos de renovación.

La iniciativa CHIME (en inglés) puede ser consultada en: congress.gov.


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Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"