July 18, 2019

To the Iowa Congressional Delegation:

As you know, our coalition of Iowa’s health care and human service consumers, workers,
providers, and insurers has been paying close attention to the debate over access to health
care and funding for health care services in Congress.

We are particularly concerned about the future of programs and institutions that affect millions of
low- and moderate- income families and their healthcare providers, including the Medicaid
Disproportionate Share Hospital (DSH) program and Federally-Qualified Health Centers
(FQHC).

The DSH program provides vital support to 11 Iowa hospitals that serve a disproportionate
number of Medicaid beneficiaries and uninsured patients. The proposed cuts to the program –
about ​$6.6 million​ for Iowa hospitals in the first year and double that the following year – are
unsustainable for struggling safety net hospitals, especially in rural areas, and could force some
of them to reduce services or even close their doors.

Federally-qualified health centers are community-based clinics that provide preventive and
life-saving treatment to patients with no other options, regardless of their ability to pay. These
FQHCs rely on the Community Health Center Fund (CHCF), which help them keep their doors
open, expand services, and improve the quality of care for low-income Iowans.

We strongly urge you to support ​the Community Health Investment, Modernization, and
Excellence (CHIME) Act ​(H ​ .R. 2328​) – a bill to extend funding for the Community Health
Center Fund (CHCF) and National Health Service Corps (NHSC) for five years, starting at $4.2
billion and $325 million, respectively. This bill also delays more than $7 billion in cuts to the
Medicaid Disproportionate Share Hospital (DSH) program, as well as reduces the cut to DSH in
2022 by $4 billion.

Many of you have previously expressed strong support for these programs, which help ensure
that Iowans from every income level have access to high-quality healthcare in all parts of the
state. Now, with continued uncertainty about funding worrying consumers and providers alike,
we ask that you do everything you can to address these issues promptly.

Sincerely,

● Iowa Citizen Action Network

● AFSCME Council 61
● South Central Iowa Federation of Labor, AFL-CIO
● Iowa Alliance for Retired Americans
● Iowa Main Street Alliance
● Americans for Democratic Action Iowa
● Indivisible Iowa
● National Association of Social Workers, Iowa Chapter
● Iowa State Education Association
● Progress Iowa