Florida's Community Health Centers are raising concerns about their own financial health due to what they've said are inadequate Medicaid reimbursement rates.
The centers are urging lawmakers to adjust the rates to cover what they've found to be a gap of $106, or just over 42%, for every Medicaid patient visit.
Bradley Herremans, CEO of Suncoast Community Health Centers in Hillsborough County, said filling the funding gap could enable them to expand services and even open new clinics, while failure to do so would force them to curtail or close some services, disproportionately affecting low-income populations.
"The population is just growing exponentially around here, and that just drives the additional need for additional services," Herremans explained. "You can kind of see where you start to get that 'crunch,' between revenue and what's expected of a Community Health Center."
Sen. Kathleen Passidomo, R-Naples, president of the Senate, achieved unanimous passage of her "Live Healthy" proposal, Senate Bill 7016, touted as a plan to increase the state's health-care workforce. Health centers are optimistic lawmakers will address funding gaps in budget negotiations between the House and Senate.
Jonathan Chapman, president and CEO of the Florida Association of Community Health Centers, said they comprise 54 centers spanning over 800 locations. He does not expect any one entity to make them whole.
"We're looking at a $40 million 'ask' of state recurring funds," Chapman pointed out. "This would also be leveraged with federal dollars, so with the state's $40 million investment, we would actually leverage that and it would be close to a $100 million investment, which really equates to about $22 per FQHC patient."
FQHCs are Federally Qualified Health Centers. Annually, Chapman said the centers provide care to 1.8 million patients, with 51% covered by Medicare or Medicaid, and 28% uninsured. He added more than 87% of patients served by Community Health Centers live below the Federal Poverty Level.
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As Congress reviews budget slashes to health care in President Donald Trump's "One Big Beautiful Bill Act," a new evaluation from the nonpartisan Congressional Budget Office projects 16 million Americans, including 1.8 million Medicaid and Healthy Indiana Plan recipients, would go without health insurance.
If the bill passes as is, said Josh Bivens, chief economist at the Economic Policy Institute, a nonpartisan think tank, health providers would see a sharp increase in what is known as uncompensated care, when people without coverage get sick but are unable to pay.
"And it means hospitals and doctors no longer receive that income stream from Medicaid payments," he said. "And lots of them are going to be forced out of business, and there's going to be closures of hospitals, especially in rural counties."
Republicans question the Congressional Budget Office projections, believing that cutting $715 billion from Medicaid eliminates fraud. They want to add specific work mandates for healthy working-age adults. The GOP bill aims to fund Trump administration priorities, including more immigration raids and border wall construction, and extending tax cuts passed in 2017.
According to the research site KFF, nearly 569,000 Hoosiers are enrolled through the Affordable Care Act's Medicaid expansion.
Bivens said he fears that if the bill becomes law, he sees the measure as a transfer of income from vulnerable families to already wealthy Americans. He noted that the average cuts to Medicaid, which would take effect after the 2026 midterm elections, would be more than $70 billion per year.
"And then if you look at the tax cuts that will be received by just people making over $1 million per year, those are $70 billion as well," he said. "We're going to take $70 billion away from poor families on Medicaid, and we're going to give it to families who are making more than $1 million per year."
Six Nobel laureate economists have signed an open letter opposing cuts to safety-net programs in the budget reconciliation bill, warning the measure would add $5 trillion to the national debt.
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As Congress considers cuts to safety net programs in what Republicans are calling the "One Big Beautiful Bill Act," a new analysis from the nonpartisan Congressional Budget Office estimates 16 million Americans, including 140,000 in Colorado, would lose Medicaid health insurance.
Josh Bivens, chief economist at nonpartisan think tank the Economic Policy Institute, said if the bill passes as-is, health providers would see a steep increase in what is known as uncompensated care, when people without coverage get sick but cannot afford to pay their medical bill.
"It means hospitals and doctors no longer receive that income stream from Medicaid payments," Bivens pointed out. "Lots of them are going to be forced out of business and there's going to be closures of hospitals, especially in rural counties."
Republicans have cast doubt on the Congressional Budget Office projections and claimed cutting $715 billion from Medicaid by eliminating fraud and adding work requirements for adults would not reduce coverage. The GOP bill aims to fund Trump administration priorities, including more immigration raids and border wall construction, and extending tax cuts passed in 2017.
Bivens stressed if the bill becomes law, it would result in what he describes as the direct transfer of income from vulnerable families to the richest Americans. He noted the average cuts to Medicaid, which would kick in after the 2026 midterm elections, would be more than $70 billion a year.
"Then if you look at the tax cuts that will be received by just people making over $1 million per year, those are $70 billion as well," Bivens explained. "We're going to take $70 billion away from poor families on Medicaid, and we're going to give it to families who are making more than $1 million per year."
Six Nobel laureate economists have signed an open letter opposing cuts to safety net programs in the budget reconciliation bill, warning the measure would add $5 trillion to the national debt.
While headlines about the latest Trump-Musk feud may catch more people's attention, Bivens added the bill will have the biggest effects on Coloradans.
"I think the fact that six Nobel Prize winners said, 'This is important enough for me to try to draw attention to the implications of this bill,' should make people realize the stakes are really large," Bivens emphasized.
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A New Mexico coalition is stressing an urgent need for the state to adopt the strongest possible heat risk standards for indoor and outdoor workers.
New Mexico is the sixth-fastest-warming state in the nation, according to the Union of Concerned Scientists, fueled by climate change which makes heat waves more common.
Carlos Matutes, community advocate for the environmental group GreenLatinos, said 80% of those working in agriculture are Latino, as are 64% of those working in the building trades. He added Latino workers are overrepresented in oil and gas production and need to be protected.
"Depriving them of paid rest periods, of shade, of water during the summer months is unconscionable," Matutes asserted. "We're trying to make sure New Mexico Environment Department establishes these rules as quickly as possible."
Two states, Texas and Florida, have passed laws limiting local governments' ability to require employers to provide water breaks to outdoor workers. In contrast, California adopted protections in 2006. Matutes noted the Environmental Department has already announced the process to consider a heat-protection rule has been delayed and will not take effect before workers endure this summer's heat.
It is not just workers who suffer from extreme heat but also kids in school classrooms.
Whitney Holland, president of the American Federation of Teachers-New Mexico, said the days of putting a box fan in a classroom window on hot days are long past and the number of sweltering days increases each year.
"Thinking through a student's day, from the time they get on the bus, with buses that don't have air conditioning, in the cafeteria, in the library, all of those places," Holland outlined. "If they don't have proper ventilation and good air quality, research shows students feel fatigued, they are unable to focus, all of those things."
As might be expected, Holland added late afternoon, following the lunch break, is when students are most miserable, which disrupts the learning environment. This summer's forecast calls for hotter-than-normal temperatures from coast to coast, according to NOAA's Climate Prediction Center.
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