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Health care for poor and kids could be upended by budget battles

Martha Cardenas, a 23-year patient of Community Health Service, gets her blood pressure measured by nurse June Nelson during a visit Monday, Dec. 18, 2017, in Moorhead, Minn. Federal funding for this program, and others like it, is in jeopardy. Michael Vosburg / Forum News Service

FARGO — Federal funds for the region's community health centers and the Children's Health Insurance Program, better known as CHIP, got a temporary boost with the stopgap spending bill approved by Congress on Thursday, Dec. 21, keeping those programs running through March.

Pat Gulbranson views the funding as a much-needed gift.

"Well take it. It's a nice Christmas gift at this point," said Gulbranson, CEO of Family HealthCare here.

Without an agreement by lawmakers, Family HealthCare could have faced a 70 percent cut in funding — more than $1.8 million — by the end of February, threatening care for more than 16,000 low-income or homeless people at its four clinics in Fargo, West Fargo and Moorhead, Gulbranson said.

Gulbranson is "cautiously optimistic" a longer-term deal can be hammered out between Democrats and Republicans.

"We're still advocating for a long-term funding fix. Ideally, a three- to five-year funding fix for the health centers," Gulbranson said. "It (the stopgap measure) buys us a little bit of time, but a month goes by pretty quick."

Moorhead-based Community Health Service could see a budget cut of 60 percent, or $2.5 million, if a long-term budget agreement fails to appear, said Executive Director Kristi Halvarson.

That would affect 3,000 patients who count on Community Health to be their primary health-care providers in Moorhead, Willmar, Crookston and Rochester, Minn., Grafton, N.D., and through two mobile clinics.

"With that big of a hit, we'd have to consider either layoffs or site closures," Halvarson said.

The Children's Health Insurance Program provides medical, dental and vision coverage for children (and pregnant women) whose families earn too much to qualify for Medicaid, but too little to pay for private insurance.

Long-term funding for CHIP had halted Sept. 30.

In North Dakota, there was enough money to keep the program running until May 2018, the Department of Human Services announced.

CHIP covers nearly 2,800 North Dakota children. The state received $21.9 million in the 2017 federal fiscal year for CHIP.

But Minnesota was among 16 states expected to exhaust their CHIP funds before the end of January, according to the Kaiser Family Foundation. State officials had declared that they'd find money in the state's coffers to continue care for 125,000 children.

Donene Feist, executive director of Family Voices of North Dakota, says CHIP, which serves 8 million people around the country, is crucial for families whose children have chronic diseases such as asthma or diabetes, or require care for cancer.

"The way our health system is right now, those kind of medical costs could throw them (CHIP-qualifying families) into bankruptcy in no time at all," Feist said.

She wants Congress to approve long-term funding.

"No family should live like this from month to month, worrying about, 'What if?' There's a whole lot of uncertainty out there. Needless uncertainty," Feist said.

Congressman Kevin Cramer, R-N.D., agrees.

"The goal is to get a five-year funding bill" for CHIP and community health care centers, he said Friday night

"CHIP is pretty high priority" for both parties, but there have been differences between Republicans and Democrats on how the program should be funded, he said.

"The one thing about CHIP and community health centers is, really, no one opposes them that I know of," Cramer said. "People in both parties, in both sides of the Capitol, are pretty strongly committed to it."

Sen. Heidi Heitkamp, D-N.D., said in a news release she didn't like the lack of a long-term resolution.

"I'm disappointed that (CHIP) was only extended for three months," Heitkamp said. "This program is about life and death, and the families who rely on it need long-term certainty to know that their kids will be protected."

Halvarson hopes Congress locks in long-term funding for health programs.

Not having Community Health Service open would shred a piece of the social safety net for her agency's clients, she said.

"They would lose a place where they've been coming for care for 40 years sometimes. ... It's people that really don't have a lot of options," Halvarson said.

Helmut Schmidt

Helmut Schmidt was born in Germany, but grew up in the Twin Cities area, graduating from Park High School of Cottage Grove. After serving a tour in the U.S. Army, he attended the University of St. Thomas in St Paul, Minn., graduating in 1984 with a degree in journalism. He then worked at the Albert Lea (Minn.) Tribune and served as managing editor there for three years. He joined The Forum in October 1989, working as a copy editor until 2000. Since then, he has worked as a reporter on several beats, including K-12 education, Fargo city government, criminal justice, and military affairs. He is currently one of The Forum's business reporters.

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