Government Affairs
& Advocacy
We influence and advance policy that underpins
thriving and sustainable health center services.
Advocacy Issues
340B Contract Pharmacy State Protections
Issue:
Ensuring access to pharmacy services is an essential part of the health center model and an important aspect of providing high-quality care to the patients that health centers serve. The federal 340B Drug Pricing Program provides health centers and other 340B entities access to outpatient drugs at a reduced price. Health centers use the savings from those reduced prices to offer cheaper prescription drugs to eligible patients who don’t have drug coverage and to support other patient services their organization provides, allowing health centers to stretch their scarce resources. While every health center decides how its 340B savings can best benefit its patients, these savings often support clinical pharmacy programs, extended evening and weekend hours, case management services for at-risk community members, and sliding fee discounts for healthcare services– ultimately increasing patient access to care. Currently, however, the 340B program is facing challenges from pharmaceutical manufacturers, which limit access to reduced-price drugs or make it more difficult for health centers to receive drug savings.
Many pharmaceutical manufacturers have made it more difficult for 340B entities like health centers to benefit from the savings associated with discounted drugs. They do this by restricting the number of 340B contract pharmacies to which discounted drugs can be distributed. Those savings are a critical part of how health centers serve their patients and sustain their operations, and they are required by federal law to be reinvested into health center programs and services. Health centers are subjected to detailed requirements and federal oversight that they must adhere to, which guide their participation in the 340B program to ensure savings received are appropriate. Beyond the fiscal problems the limitation of contract pharmacies causes, the restriction on the number of contract pharmacies can cause issues with patients having access to discounted medications due to the distance they may have to travel to get to a 340B pharmacy.
Recommendation:
MPCA recommends supporting legislation that would prohibit pharmaceutical manufacturers from limiting the number of 340B entities’ contract pharmacies.
Health Centers Careers Training Program (HCCTP) Permanence
Background:
The Health Center Careers Training Program (HCCTP) was launched in March of 2022 with an investment from the Michigan Legislature to train and employ new healthcare professionals, addressing critical areas of health workforce shortage across the state. Participating health centers serve as partners in providing on-the-job training, trainee support, and employment for a variety of in-demand healthcare careers. Financial resources appropriated by the legislature are a workforce development investment that helps individuals in communities pursue healthcare occupations, including covering the cost of training and education.
MPCA is approved by the U.S. Department of Labor to serve as an Intermediary for health centers transitioning their training programs into Registered Apprenticeship Programs. The HCCTP has enabled rural, urban, and tribal health centers to grow local talent and provide economic opportunities within the communities they serve. MPCA is actively exploring new opportunities to build on the program’s success by innovating apprentice-style training within Michigan’s health centers.
Recommendations:
Reinvest in the Michigan Health Center Careers Training Program (HCCTP) to sustain and expand on-the-job training and registered apprenticeship programs that surmount barriers to entering health professions and rapidly grow the workforce. The investment is needed to meet healthcare needs in Michigan’s low-income and medically underserved communities. Supporting permanent funding ($2 million per year) for the HCCTP program to enable Michigan Health Centers to sustain their newly established training programs for entry-level health careers and to grow innovative training program models critical for providing health care in many communities across the state.
Medicaid
Background:
Informed by the research of national partners, MPCA estimates over 78,000 patients- the equivalent of 1 in 8 patients served by Michigan health centers today- will lose their health insurance coverage through Medicaid or the Marketplace because of changes in federal law, including the impact of Medicaid work requirements, increasing the frequency of Medicaid redetermination, and the loss of enhanced premium tax credits in the Health Insurance Marketplace. Losing affordable health insurance coverage will have a profound effect on health center patients by reducing their access to care, increasing delayed or forgone healthcare, and intensifying financial strain and the likelihood of medical debt- all leading to poorer health outcomes.
Impending changes to the health insurance coverage programs will negatively impact the stability of health center services for everyone, not only those losing coverage. MPCA’s estimates show that over $94 million in reimbursement for services will be lost annually because of patients becoming uninsured. $76 million of those losses are Medicaid reimbursement dollars. Health centers already operate on
razor-thin margins, and they will not be able to maintain all current healthcare services given the loss of these resources, forcing centers to scale back critical programs or even close the doors of critical healthcare service delivery sites.
Health centers are one of the best stewards of public health care dollars. Forcing individuals to seek care outside health centers jeopardizes the savings they provide.
Recommendations:
Replace half the dollars that are expected to be lost in Medicaid reimbursement. Appropriate $38 million for federally qualified health centers in the state to protect patients’ access to care and to prevent them from seeking more expensive alternative medical care.
Support the stability and sustainability of Medicaid as a critical source of health insurance coverage in Michigan.
Become a Health Care Defender
You can help shape the future of community health centers and the people they serve by joining the MPCA Grassroots Advocacy Network. By signing up, you will receive timely email updates and email action alerts about issues or legislation that can impact your local community health center.
We encourage all those who believe in and support the mission of community health centers, including health center staff, health center board members and patients, to sign up for advocacy alerts.
Looking for more? If you’re meeting with an elected official and need talking points, data, or other materials to help make your visit the best it can be, contact Natalie VanAcker, 5178270884.
Find Your Elected Officials
- Find your State Representative and District
- Contact your State Representative
- Find your State Senator and District
- Contact your State Senator
- Find your U.S. Representative and District
- Contact your U.S. Representative
- Contact U.S. Senator Elissa Slotkin
- Contact U.S. Senator Gary Peters
Please feel free to contact Natalie VanAcker (517.827.0884) or Frank Waters (517.827.0477) with MPCA if you need assistance identifying or contacting your legislator or would like to set up a visit or meeting.
We Need Your Help!
As the backbone of the health care safety net, health centers provide cost-effective primary and preventive care — including dental, behavioral health services, substance use disorder treatment, vision, and pharmacy — that helps people get and stay healthy. But what you might not know is that health centers don’t just keep people healthy: they also help create a healthy economy. Here in Michigan, health centers employ nearly 6,000 people and help create almost 40,000 jobs throughout the state. Health centers also generate more than $1.3 billion in total economic stimulus, making them economic powerhouses in underserved communities.
But health centers are struggling.
COVID-19 has resulted in millions of lost revenue and stretched health center resources to its limits, with more patients to serve.
In the aftermath of COVID-19’s negative effects on both the health care system and the economy, community health centers will be an even more critical resource to serve our neighbors and their families so that they can continue to access primary care, even if they lose their employer-sponsored insurance plan.
Additionally, health centers have been on the defensive as important programs like the 340B Drug Pricing Program that help fund a variety of essential services face strong threats.
Health Centers need to continue to advocate to:
- Ensure the Health Center program is properly funded by Congress each year.
- Protect the 340B Drug Pricing Program.
- Increase funding for workforce programs to ensure that trained medical staff are available.
- Ensure that expansions of telehealth services in Michigan during the COVID-19 epidemic are made permanent.
- Adopt an Alternative Payment Methodology to ensure that payment is based on quality, instead of quantity, of services.
Please take a look at the following resources to learn about being an effective advocate:
- The 340B Drug Pricing Program
- National Association of Community Health Centers Health Advocacy Network
- Advocacy Center of Excellence (ACE) Program
- Michigan Citizen’s Guide to State Government
Contact your elected officials and let them know about the essential role that health centers play in your community. Please click on the link, Find Your Elected Officials.
Voting Resources
MPCA is proud to partner with Vot-ER to provide our members and communities with easy access to voter registration tools, register to vote or find voting information here: vote.health/mpca