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National Association of Community Health Centers Annual Policy and Issues Forum

March 23, 2011
Washington, DC

Remarks as prepared for delivery

Thank you Anita for that kind introduction and for your leadership both here in Washington DC and in Washington state.

I also want to thank Tom for that introduction and for your incredible commitment to America’s community health centers over nearly three decades.

And a special thank you to Vicki Kennedy for her very moving remarks. Vicki has been an unwavering partner and champion for some our nation’s most vulnerable people.

I want to recognize the Board, staff, and all the members here today who help community health centers provide the high-quality, affordable care that millions of Americans count on every day.

Finally, I want to give a special thank you to all those who are taking time out of their busy days to listen in from community health centers across the country.

As you know, it was one year ago today that the president signed into law the landmark Affordable Care Act. And I couldn’t think of a better place or better people with whom to celebrate this important anniversary.

The leaders in this room and in community health centers around the country didn’t just make the case for reform. You have shown the way forward, demonstrating that it’s possible to deliver high-quality, affordable care in some of our most underserved communities.

Patient-centered care. A focus on prevention. Coordination between health care providers. This is the type of care that community health centers provide, that all Americans deserve, and that thanks to the Affordable Care Act they soon will have.

As you know, the Affordable Care Act is already making a difference in the lives of millions of Americans across the country. There’s been a lot of commentary about what’s happening. Some of it’s confusing. Some of it’s deliberately misleading. So I think it’s important to remind people of a few key points.

First, we’re ending discrimination against pre-existing conditions. Thanks to the law, insurers can no longer turn children away just because they were born with a disability or have asthma. That’s no longer allowed. And in 2014, all 129 million Americans with pre-existing health conditions will be free from discrimination because of their health status.

Second, we’ve given Americans the protection of a new Patient’s Bill of Rights that’s outlawed many of the worst abuses of the insurance industry. Now, insurers can no longer cancel your coverage because of a mistake on your application. And they can’t put an arbitrary lifetime cap on your benefits.

Third, we’re taking long overdue steps to bring down health care costs for families and small businesses. There are new rules to limit the share of your premium insurers can spend on overhead like CEO bonuses and marketing. There are new resources to help states stop unreasonable rate increases. And up to four million small businesses are eligible for a tax credit this year to help them pay for health insurance.

Fourth, we’re strengthening Medicare. Yesterday, we announced that nearly four million seniors who hit the Medicare coverage gap in 2010 have received $250 checks to help them afford their medications. Some of them even mailed me their receipts to show how they spent their money. And starting this year, seniors can also get critical preventive care like cancer screenings without paying any co-pays or deductibles.

These are just a few of the ways that the law is making it easier for Americans to get the care they need. And today, I’m glad to be here with you to talk about another important way the law is making a difference in Americans’ lives which is by expanding and supporting the extraordinary work that all of you do every day.

In 1965, two doctors named Jack Geiger and Count Gibson opened the first two neighborhood health centers with federal support in Boston and Mississippi.

And when a young Senator from Massachusetts saw what Jack and Count had created, he knew he had to spread this model across the nation. So in 1975, Ted Kennedy got Congress to enact legislation making the community health center program permanent, adding another achievement to a legacy that was crowned with the enactment of the Affordable Care Act just a few months after his death.

Jack Geiger, Count Gibson and Ted Kennedy shared a simple belief: that every single American deserves access to high-quality health care from a clinician in their community.

And in the last 45 years, that basic principle has helped those first two community health centers grow to more than 1,100 with over 8,000 sites.

In 2009, these community health centers provided care for 19 million of the neediest Americans. Today, community health centers are not just the place where people go when they get sick.

Community health centers are where Americans go when they need a check-up and to get their teeth fixed. It is where parents turn when they need counseling or support finding a job or help enrolling their children in the CHIP program or an after-school program.

You provide a true health home for your patients, which is part of the reason your patients do so well. Compared to other patients, health center patients control their blood sugar better. Babies delivered at health centers are less likely to have low birth weights. And you do it all while keeping costs down.

That’s part of the reason community health centers have traditionally had broad support from Democrats and Republicans. When it comes to delivering high-quality care…to the people who need it most…in their own communities…on a broad scale….no one does it better than community health centers.

But we also know that community health centers often haven’t had the resources you need to meet the full health needs of the people you serve. Many of you offer the dental or mental health services that are just as important as medical care. But too many can’t afford to offer these critical services.

Some have backlogs of patients. Others know they could reach even more people if they opened a satellite clinic, but simply don’t have the money to do it.

That’s where the health care law comes in. By expanding health coverage, strengthening our health care workforce, emphasizing primary care and prevention, and providing a historic boost in funding, the Affordable Care Act will help community health centers provide more high quality, affordable primary care to millions more Americans.

One of the biggest ways the law will make a difference is by expanding coverage to 32 million Americans who would otherwise lack insurance.

Nearly half of those people will be covered by an expansion of Medicaid. And that means that many of the people who were previously coming to you without insurance will now have a Medicaid card, allowing you to be reimbursed.

There will also be better health insurance options for families and small business owners. For years, the health insurance market has been broken for those who buy insurance on their own—a group that any of us could fall into if we switch jobs, retire, or start our own business.

But starting in 2014, there will be new state-based Exchanges where Americans who had been shut out of the market will be able to get affordable coverage.

But with more people coming into the system, we know you will need help to meet the demand.

That’s why we’ve undertaken a broad effort to expand our health care workforce to meet the needs of our people, from almost doubling the size of the National Health Service Corps to making it easier for minority students to fulfill their dreams of joining a health profession.

When you add all these initiatives together, we’re going to train 16,000 new primary care providers over the next five years, many of whom will practice in the rural and inner-city communities where they’re needed.

And once these providers join the primary care workforce, we want them to stay there. So we’ve also changed our payments to doctors under Medicaid and Medicare to better reflect the important role of primary care.

We also know that in many communities, you simply need more capacity and better infrastructure.

That’s why we fought to make sure the Recovery Act contained a $2 billion investment in community health centers, supporting everything from new buildings to new services to new staff to new technology.

And that’s why the Affordable Care Act is adding another $11 billion in funding. The two laws combined will help America’s community health centers to serve nearly twice as many patients as before.

Across the country, these investments are making a huge difference.

In Hyannis, Massachusetts, for example, the Duffy Health Center cared for more than 2,500 homeless and at-risk clients in 2009. They had 23,000 visits to three different buildings, stretching their resources to the limit.

But with funds provided under the Affordable Care Act, Duffy began construction of a new Main Street facility last April. When it’s completed this summer, all 52 staff will move to a new 14,000 square foot building, nearly 75 percent larger than their old space, with five additional exam rooms under one roof, making it easier to coordinate care for patients.

But we’re not stopping there. As we strengthen and expand community health center facilities, we’re also investing in the community health center approach to care.

Community health centers have long understood that the best way to keep people healthy is to provide high-quality primary care that can prevent health problems or catch them before they become serious.

We agree. That’s why as part of the health care law, all Americans in new health plans will get recommended preventive care like immunizations and cancer screenings at no additional cost. The days when a mom would skip a potentially life-saving mammogram because she couldn’t afford the co-pay are coming to an end.

Community health centers have also been leaders in providing integrated care. You don’t just write your patients a prescription or a mental health referral and then send them away.& Your pharmacy and psychiatrist are next door in the same building. Your staff knows your patients and their families. You follow up to make sure they’re taking their medicine or making their appointments.

We know from dozens of other examples across the country that this kind of coordinated care, in which health providers work together to keep patients healthy, is often much more effective than the fragmented care too many Americans receive.

That’s why last fall, Mary Wakefield and her tremendous team at HRSA launched a new initiative to help encourage health centers to gain patient-centered medical home recognition, allowing them to demonstrate their leadership as providers of high-quality care.

And that’s why the health care law contains significant new support for these models of care. For example, one of the first projects at the new Center for Medicare and Medicaid Innovation will look at how we can provide patient-centered, coordinated care to treat low-income Medicare patients at as many as 500 Federally Qualified Health Center sites.

When you add all these provisions in the Affordable Care Act together, they will take the high-quality, affordable, patient-centered care that so many Americans get at community health centers today, and make it available to millions more.

Yet this progress is being threatened by people who continue to push to repeal or defund the Affordable Care Act. They spout slogans but ignore the fact that their actions would have terrible consequences for people in need of care and assistance.

I can’t think of a worse idea.

If these cuts were passed, thousands of health care providers across the country would lose their jobs. And millions of Americans in the most underserved rural and urban communities would lose access to their best source of affordable health care.

As a result, those folks will come through the doors of emergency rooms in larger numbers, putting a growing burden on already strained state and city budgets. They will be sicker on the job. They will be unable to take care of their kids. There will be students who won't do as well in school because their health needs won't be attended to.

This will threaten not just the health of our country, but also our prosperity.

We can’t afford to let that happen.

I want you to know that President Obama and I are committed to protecting and supporting community health centers, today and in the months and years ahead.

For the last 45 years, you have lead the way, confronting some of our greatest public health challenges, generating growth, creating jobs, raising quality, and providing affordable care for some of our country’s most vulnerable people.

The challenges today are no less daunting, but together we can ensure every American has access to quality care in their community.

Thank you.