[Congressional Record Volume 163, Number 188 (Thursday, November 16, 2017)]
[Senate]
[Pages S7290-S7291]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mr. KING. Mr. President, I did a mathematic calculation a couple of 
years ago, and it resulted in an interesting conclusion. The Senate is 
a rural body. Eighteen Members of the U.S. Senate represent a majority 
of Americans. That means 82 percent--or 82 out of 100 Senators--
represent smaller States, more rural communities.
  Today, I want to talk about a disastrous development that is headed 
for our rural communities that we have the capability to fix, and it is 
one we should fix sooner rather than later. I am talking about Federal 
funding for federally qualified health centers, which expired on 
October 1. Seventy percent of the funding for the FQHCs expired on 
October 1. One hundred percent of the National Health Service Corps 
funding expired on October 1.
  These are vital programs that serve rural America and provide 
incredibly important healthcare services. They are an overlooked part 
of our national healthcare system, in part because they are 
traditionally in rural and outback locations.
  In Maine, we have 20 centers and 70 facilities scattered all over our 
State, and they are providing services every day to over 200,000 
people. This is a vital part of our healthcare system. Yet the funding 
expired at the end of September, and so far nothing has been done.
  How important is it? In Maine, there are 1,700 employees at these 
facilities; a total economic impact of over $300 million a year; $8 
million in State and local tax revenue and $32 million in Federal tax 
revenue. They provide $16 million worth of uncompensated care that goes 
to Maine people who need the help. They are efficient. In Maine, they 
have saved Medicaid over $100 million, and $257 million is the estimate 
for what they have saved the overall healthcare system. Again, FQHCs 
provide 1,700 jobs and support another 1,000 jobs in their communities.
  But this isn't only about economics and economic development and 
jobs; it is about healthcare. One in six people in Maine gets their 
healthcare from FQHCs--210,000 people. They accept everybody who comes 
to their door. I have been to them all over the State. They use a 
sliding-fee scale for people who are low income, who don't have 
insurance, and they provide all manner of services. It depends on the 
center; different centers have different services. They have medical, 
behavioral health, dental, substance abuse treatment and support, case 
management, optometry, podiatry, OB/GYN, prescription assistance, 
outreach and enrollment, pharmacy, radiology, and school-based 
healthcare services. These are the healthcare providers for rural 
America. And it is not only Maine; it is across the country. There are 
10,000 sites across the United States. Some 26 million patients are at 
risk.
  Well, what is the big deal? The big deal is that people are going to 
lose their healthcare services. We estimate that in Maine, we are going 
to lose about 400 clinicians and administrative and support staff who 
will have to be laid off at the beginning of the year unless we solve 
this problem in the immediate future. At least 25 of these sites will 
be forced to close, and we believe there will be almost 30,000 Maine 
residents who will lose access to their healthcare system.
  Most of the FQHCs--federally qualified health centers--are getting by 
on their funding from last year, so the expiration of the funding 
hasn't hit them yet, but it will begin to hit them on January 1. That 
is what we have to respond to.
  It is also already having an effect just by creating uncertainty. I 
got an

[[Page S7291]]

impassioned letter from the leader of one of our centers in Maine about 
the fact that they have been very diligently recruiting a dentist to 
come to their community. Dentists are very hard to come by in rural 
America. They had one who was ready to come, and then suddenly they 
heard about the uncertainty surrounding the funding--that it may or may 
not come through--and that dentist is now reconsidering their decision 
to go to this Maine community. That is a tragedy. That is a tragedy for 
the people of that town, where these services are literally not 
available.
  So what does it matter? It matters because we are talking about 
people losing their healthcare services.
  This has never been a partisan issue. I don't think there is a heck 
of a lot of debate around here about the importance of FQHCs and that 
we need to get them refunded. In fact, the Presiding Officer and 
Senator Stabenow have sponsored a bill, the CHIME Act, that would 
resolve this issue. We just need to get it on the floor and get it 
done.
  We have proved today by the passage of the National Defense 
Authorization Act that we can take major issues, bring them to the 
floor, and move them forward, especially those that aren't particularly 
controversial. But my concern is that even though there doesn't seem to 
be controversy, it is just not happening, and now our centers are 
having to make plans for layoffs, for closures, and for closing their 
doors to the people who need the care.
  This is something we can do. This is something we can resolve. It is 
within our power. The legislation is ready to go, and we should get 
this done.
  We are leaving today for the Thanksgiving holiday, but if we leave at 
the end of the year and haven't done this, it will be a tragedy for 
rural America. It will be a betrayal of rural America. It will be a 
betrayal of our constituents.
  All of us have been to these centers and seen the care that they 
provide, the caring that they provide, the passion that the people 
bring to the services in their communities, and how much they mean to 
their communities. This is one of the best Federal programs ever 
created, and it has always been supported on a bipartisan basis.
  I urge my colleagues today to prepare ourselves to get this done as 
soon as we possibly can when we get back after Thanksgiving. We have so 
much to be thankful for, and I want my people in Maine to realize that 
they can be thankful for those health centers that are literally 
lifelines in their communities and mean so much to them. I believe this 
is something we can and should and will do.
  Thank you, Mr. President, and thank you for being a leader on this 
issue.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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