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Community Health Alliance: A Safety Net In Northern Nevada

Throughout the nation, community health centers are providing care to low-income people. And with the overhaul of the Affordable Care Actbeing debated, Reno Public Radio’s Anh Gray tours one local facility to learn how it’s been serving as a health care safety net for many in Northern Nevada.

Nearly two dozen people, young and old, are waiting in the lobby of Community Health Alliance—or CHA—on Wells Avenue in Reno. CHA is a Federally Qualified Health Center. Chuck Duarte is the CEO.

“A Federally Qualified Health Center is really a center that’s established to serve people who otherwise wouldn’t have access to health care services, Duarte explains. “So regardless of their ability to pay, we’re here to help take care of them.”

CHA operates six different centers throughout the region. The one on Wells is their biggest and provides primary care, dental services, and behavioral health services like substance abuse treatment. They serve about 30,000 people annually and about 80 percent of those patients have household incomes below the poverty line.

“If we weren’t here, the option would be to find a private provider, which would be very difficult to find particularly without insurance, or to go to the emergency room and to the urgent care centers,” Duarte says.

The center accepts Medicaid, Medicare, commercial insurance and also operates on a sliding fee scale. Nevada health policy expert John Packham says the Affordable Care Act provided a boost.

“The Affordable Care Act resulted in more paying customers,” Packham explains, “primarily Medicaid customers and low-income individuals being able to access care.”

CHA has actually seen the number of uninsured patients drop from 40 percent down to 20 percent in 2014. That’s because in Nevada, the ACA enabled about 300,000 to qualify for Medicaid and nearly 90,000 more enrolled through the state health exchange.   

At CHA, Eva Leon oversees the operations at the Wells Avenue location. She offers me a tour of the facility, including the dental wing, which includes several vibrant, colorful rooms.

“I always like to show this room, this is my favorite room out of the whole CHA,” Leon says. “We had a local artist that come in and do work, and they did this whole mural of an Indian Jones as a tooth hanging off a branch by floss.”

Indiana Jones as a tooth mural in dental exam room at Community Health Alliance.

As we’re passing through, we run into the center’s Medical Director Dr. Eithne Barton who’s getting ready to see a patient. I ask her what it’s like to be a doctor while the ongoing national debate about the ACA is taking place. 

“It’s just there are too many hurdles and barriers to care that should not exist with insurance,” Barton says.

Barton says that even though CHA is the largest provider of Medicaid in Northern Nevada, it doesn’t mean her patients have access to everything.

“We even struggle today for our folks who are on Medicaid,” Barton explains. “We don’t have specialists that are able to see them in the community because they are not credentialed with a certain insurance. It will be that much harder if we take that access away.”

Recently, House Republicans released their proposal to amend the ACA. And conservatives from the House Freedom Caucus voiced oppositionto the bill saying that it’s keeping too many Obamacare provisions.  

Some Republicans like Congressman Mark Amodei say there’s uncertainty. He addressed the Nevada Legislature earlier this week pointing to there many unanswered questions.

“So another question that comes up is how is this going to reduce cost? Because if it’s not, what about pharma? What about insurance company regulations? What about all those things?

Admodei has criticized Obamacare for failing to achieve health care reform and placing a burden on businesses.

According the publicationThe Hill, Republican Senator Dean Heller recently told his constituents that Nevada needs more time to respond the plans for Medicaid changes. He also says the Senate should be able to amend the House proposal.

The Congressional Budget Office estimates that in a decade, as many as 24 million people could lose health insurance if the House Republican health bill passes. Some Republicans refute that number as being inflated.

Anh Gray is a former contributing editor at KUNR Public Radio.
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