BROWNSVILLE, RGV – To boost community support for Medicaid expansion in the Rio Grande Valley, the website is going to be made available in Spanish in the next few weeks.

The website, which is currently only available in English, was promoted at a news conference at the Brownsville Community Health Center on Friday. Health center administrators said the website has all the relevant information on how, by closing the coverage gap, Texas can protect the state’s healthcare safety net and at the same time save money.

The website’s home page has the startling information that Texas is set to lose $2.39 billion to other states because it has chosen not to close the coverage gap for the poorest adults under the Affordable Care Act (ACA). That equals $113 per second, or $6,829 per minute, or $409,753 per hour, or $9,832,386 per day.

“Our community needs to be informed so they should go on the website. Learn about the status of the funding,” said Paula Gomez, executive director of Brownsville Community Health Center and Horizon Medical Center. “We hope everyone in the Rio Grande Valley will be interested because it affects everybody, whether you are a patient at a community health clinic or not. This issue affects the entire community. “

Lucy Ramirez, CEO of Nuestra Clinica del Valle in San Juan, agreed. “We need the web site to be launched in Spanish. I am pleased that is happening, in the next couple of weeks,” Ramirez said.

Nuestra Clinica del Valle patient Mary Hernandez and CEO Lucy Ramirez, and Brownsville Community Health Center Chair Eddie Garcia and Executive Director Paula Gomez.
Nuestra Clinica del Valle patient Mary Hernandez and CEO Lucy Ramirez, and Brownsville Community Health Center Chair Eddie Garcia and Executive Director Paula Gomez.

Ramirez explained that uninsured, low-income workers making between 100 and 400 percent of poverty can now receive subsidies to help purchase affordable health coverage in the Health Insurance Marketplace. However, she said, because of Texas’ decision to turn down federal funds to close the coverage gap under the Affordable Care Act, uninsured Texans earning less than poverty wages are left without affordable coverage options. “With open enrollment a lot of our clients were upset because they tried to get coverage and found they could not. Everybody refers to is as the coverage gap or the black hole,” Ramirez said.

The decision by Texas not to expand Medicaid is going to hit federally qualified community health centers hard, BCHC’s Gomez explained. She said a five-year trust fund was set up under the Affordable Care Act to increase services at health centers in anticipation that those patients who previously lacked health insurance would use their services. However, she said, Texas patients in the coverage gap in Texas never got insurance because the Supreme Court made it optional for states to close the coverage gap and Texas chose not to.

“This trust fund, this funding cliff, was always meant to go away because the sustained funding would come from people coming in with increased health coverage,” Gomez said. “Forty seven thousand would have come through our door with insurance. That was going to be huge for us. Some of them are still coming in, but without health insurance. We cannot turn patients away because they do not have coverage.”

Gomez said BCHC wants to highlight the fact that it is headed for a “fiscal cliff” and that all community health centers are going to be affected unless something turns in the next few months. “It is slated to hit in 2015 unless Congress moves,” Gomez said.

“We have had cuts before but not to this extent. This is the worst I have seen it. We are looking at a 70 percent cut in funding, would mean we would go down to about two doctors.” Asked how many doctors BCHC has now, Gomez said 13.

Asked what the financial implications are, Gomez said: “We are going to lose close to $6 million. We collect quite a bit from our patients. They are on a sliding scale fee based on family size and income but the minimum pay is $25 for a visit. I think they are going to put off their visits to a clinic and they are going to end up in the emergency room and it is going to cost everybody a lot more money.”

Gomez added that Congress needs to “stop the fiscal cliff so we can continue to provide comprehensive primary care.” Asked if she had any comments for the community, Gomez said: “Don’t sit back and just think it is not going to happen. We have to act now.”

Ramirez, of Nuestra Clinica, said 83 percent of the clients that use her center are uninsured. “A 70 percent cut in funding would be very, very, detrimental. Although we receive fees from our clients the federal grant we receive is a good portion of our budget. We would have to shut the doors, cut services, reevaluate our locations. It would not be Nuestra Clinica as we know it. It would be very much scaled down.”

Ramirez said Nuestra Clinica has 11 clinics.

“We have reached out to our congressional delegation, the county commissioners, the cities, different school boards and others we partner with. We are trying to educate everybody about needing their support,” Ramirez said.

“The patients need to be heard. We need one voice. That is why we need the Spanish language version of the website. It should be ready in two weeks.”