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March 24, 2010; The Arizona Republic | There are 16 federally qualified health centers in Arizona and they operate 130 clinics, largely in rural and underserved areas of the state. This should be a week when they can celebrate the passing of the health care overhaul bill but instead they are looking at a number of cuts at the state level.

According to the article the cuts include: “(1) The elimination of KidsCare, a health-insurance program serving nearly 39,000 children 17 years and younger. Many children covered under KidsCare routinely visit community health centers for their primary care needs. The program, which ends June 15, costs the state $18 million a year, and the federal government kicks in $56 million. All that funding will vanish. (2) A planned $385 million cut to the state’s Medicaid program, the Arizona Health Care Cost Containment System. The program, which voters agreed in 2000 to expand with tobacco-tax money, has swelled to cover nearly 1.4 million people; about 310,000 adults will be dropped. (3)The elimination of the Arizona Primary Care Program, which used tobacco-tax and other state money to help provide basic health services, prenatal care and dental checkups to low-income residents. The program served 51,000 people in fiscal 2008 at a cost of $14.5 million, but has been sliced in recent budgets and is unfunded for fiscal 2011.”

These cuts, of course, threaten the economics of the health center system in that state and the ability of poor people to access care. In a weird twist, Governor Brewer suggested that those bounced out of coverage go to emergency rooms or to the very community health centers for service, which rely on state and federal insurance to operate. Providers seem to be harboring hopes that the state will reconsider when it realizes that it may be putting its federal Medicaid money at risk by defunding these programs. We will try to watch what states do to resist or ready themselves for the changes flowing from health reform in a bad state budget environment. Earlier, when stimulus money was released for health clinics, this Newswire noted that some states cut back on their own payments to these important mainstays of primary care in underserved communities.—Ruth McCambridge