According to Amy Simmons Farber, a spokeswoman for the health center association, these health centers suffered at least $500,000 in revenue losses each due to the dismantling of the Medicaid program.
As of the end of December, Family Health Centers, a network of clinics in Louisville, Kentucky, had lost more than 2,000 Medicaid patients since the policy change took effect in April, a decline of nearly 6 percent, said Melissa Mather, a spokeswoman for the Medicaid clinic. For every percent decrease in Medicaid patient visits, she said, the clinic suffers a loss in revenue of $175,000 to $200,000.
Bethesda is now in a “month-to-month survival game,” said Amber Greene, Bethesda's chief operating officer, who also works as a nurse. She stood in a supply closet to make her point, pointing to a modest supply of Tylenol, Motrin and thermometers donated by the church next door.
The clinic, whose vast majority of its patients receive Medicaid, needs about $115,000 each month to operate its medical and dental clinics, but still runs a monthly deficit of about $10,000. Sometimes the costs involved are small, such as the fee for the vaccination that Dr. Price administered to the mother, who was unable to pay her. But they add up and force the clinic to get creative to conserve resources. A local pharmacy offers significantly discounted antibiotics, and the clinic reduced the cost of its virus testing by conducting it itself.
Texas health officials have defended the resolution as a natural return to the intended shape and size of Medicaid. Conservative health policy experts have also argued that reducing numbers is important to sustaining the program financially.
“The reality is that many health care professionals cannot consistently treat Medicaid patients because the program reimburses so little and the application process is so torturous that many providers end up suffering losses to the point of threatening closure,” said Tanner Aliff, a health policy expert at the conservative Texas Public Policy Foundation.