'Worried about cuts': Health care providers respond to proposed HHS downsizing

Yahoo

12-04-2025

Editor's note: Federal Fallout is a Tribune-Democrat news series addressing the potential local impact of funding cuts.
JOHNSTOWN, Pa. – Hyndman Area Health Centers have five federally funded locations in Cambria and Bedford counties that provide 'vitally important' care to the underinsured and uninsured populations of those areas.
The clinics offer medical and dental services to the region, which chief executive and medical officer Brian Stratta described as needed care.
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However, with proposed cuts to the U.S. Department of Health and Human Services, Stratta said he's concerned about the future of the centers and for thousands served in the two counties. In 2024, the five locations saw 8,040 patients.
'It's hard to plan a future when there's unknowns,' Stratta said. 'The uncertainty of, 'Will that funding be there to support the infrastructure one year down the road, five years down the road?' '
HHS announced at the end of March a restructuring plan that includes reducing the workforce by 10,000 full-time jobs. When combined with an early retirement incentive and other measures, that could mean a decrease from 82,000 employees to 62,000. The plan will consolidate 28 divisions to 15 and cut regional offices from 10 to five.
Congress has also discussed decreasing the federal deficit through potential cuts to Medicaid – a health plan that allows millions around the country to receive medical care from family clinics such as Hyndman.
The Hyndman offices, one in Richland Township and another in downtown Johnstown, are federally qualified health centers, which means the clinics qualify for federal funding under Section 330 of the Public Health Service Act.
Because of that, the providers can receive enhanced reimbursements from Medicare and Medicaid as well as other benefits, offer a sliding fee scale, and provide comprehensive services, including hospital and specialty care.
'We need to provide care to those people who don't have any,' Stratta said.
He said the centers fill a need that private practices can't afford to provide due to uninsured or underinsured patient status. For example, the Hyndman mobile unit provided a mobile dental clinic in the Oakhurst Homes community room Tuesday.
Hyndman receives up to $1.6 million annually from the Section 330 funding stream and H80 grant, Stratta said, but it's unclear if all of that will be received this year.
Some of the dollars have already been drawn down, Stratta said, but in talking to other FQHC leaders, there's serious concern about not knowing what will happen next.
'We're still moving forward,' Stratta said, 'just at a slower pace than we were.'
'Life or death'
Jeannine McMillan, executive director of the Center for Population Health in Johnstown, said the programs supported by Medicaid and Medicare could mean 'life or death for many in the community.'
She and her team have been sounding the alarm regarding proposed federal cuts and government downsizing to the regional business community, elected officials and health care communities.
'I don't think that any of the populations of folks we've spoken to realize how dire of a situation this is for our agencies,' McMillan said.
Although the Center for Population Health doesn't receive any federal operations dollars – it's primarily grant- and donor-funded – McMillan said many agencies in the area do.
Area health and human services providers do everything they can to meet the 'great need in the community,' and now they're facing nearly daily changes and uncertainties, McMillan said.
The Pennsylvania Department of Human Services website shows that 35,186 residents in Cambria County are enrolled in Medicaid and 15,487 in Somerset County.
Additionally, nearly 3,000 people in Cambria County qualify for more than $9 million of assistance under the Medicaid expansion for behavioral health services created by the Affordable Care Act, and 1,289 people do in Somerset County for a total of $3.7 million.
McMillan said Cambria's Medicaid and Medicare enrollment represents more than 49% of the population in the county, which has a 13.2% rate of poverty and an 18.26% rate of disability; and Somerset County has a health assistance enrollment of more than 43% of the population, with a 12% rate of poverty and a 16.88% rate of disability.
She also said Medicaid does not provide dollar-for- dollar reimbursement for cost of care, so FQHC and community health centers, such as Hyndman, could face significant losses or closures if funding is decreased.
According to a United Way of the Southern Alleghenies fact sheet, HHS downsizing may include the Centers for Disease Control and Prevention, the Food and Drug Administration, the Low Income Heating Energy Assistance Program, National Institutes of Health and the Division of Environmental Science and Practice.
'For residents of our region, this means a weakened ability to respond to a public health crisis, fewer prescription drugs tested and made available to the public, limited cancer research, the loss of federal tobacco and smoking cessation programs, threats to food safety, no federal lead abatement programs for water systems and the loss of funding that provides home heating assistance,' the information said.
The United Way compiled this information in collaboration with the Center for Population Health, the 1889 Foundation, Vision Together 2025, Lee Initiatives Inc. and the Community Foundation for the Alleghenies.
Those type of agency partnerships are a silver lining to the situation, in McMillan's opinion.
'I think what's really good right now about the health and human services community is we've been working collaboratively for some time,' she said.
McMillan pointed to the Health and Welfare Councils in Cambria and Somerset counties that track data and trends while also partnering on community initiatives as an example of this work.
Funding cuts
One area agency already feeling the pinch of federal cuts is the Cambria County Drug and Alcohol Program.
Administrator Fred Oliveros said he's received word from the Substance Abuse Mental Health Services Administration that COVID-19 pandemic funding was terminated as of March 24 because 'the pandemic is over' and 'the grants are no longer necessary.'
That includes dollars from the American Rescue Plan Act and the Coronavirus Preparedness and Response Supplemental Appropriations Act.
The county program was awarded $70,375 from the CPRSA stream, and a combined $412,918 from ARPA – $192,000 for treatment services and $220,918 for prevention.
Oliveros said that, thankfully, the CPRSA funding was spent and a majority of the ARPA treatment money was designated as well – about $13,000 has not been reimbursed yet.
That treatment grant was used to supply methadone maintenance to 71 people and rehabilitation services to 26 people.
'If we did not have this $192,000, our budget would be hurting,' Oliveros said. 'People come to us because they don't have insurance to pay for treatments, and without these funds they would not receive that treatment.'
Although that issue was avoided, the majority of the prevention allocation was not designated before the ARPA cut was announced.
Oliveros said he planned to use around $100,000 from that source to support operations at Flood City Youth Fitness Academy from March to the end of the fiscal year on June 30 after a state Compulsive and Problem Gambling grant was expended.
Roughly $25,000 in ARPA prevention money was also budgeted for The Learning Lamp's Cognitive Behavioral Intervention for Trauma in Schools and Strong Families Program offerings.
Due to an employment change at the Drug and Alcohol Program, the contribution to The Learning Lamp programs decreased to around $4,000, which Oliveros said is a small relief, but as far as the fitness center, he's unsure what will happen moving forward.
Oliveros said there is some hope the funding may be restored because of a lawsuit about the ARPA cuts brought by several states, including Pennsylvania, although that is still being litigated.
Another contract impacted by this change is with Beginnings Inc. The county program has a deal for up to $57,598 to enhance Beginnings' Parents as Teachers program – supporting transportation and food for group connections – and at least some of that is on hold as well.
Oliveros said he's also seriously concerned about potential cuts to Medicaid, which assists with drug, alcohol and behavioral health treatments.
He noted possible cascading impacts on other systems, such as prisons, coroners' offices, hospitals and clinics, should the drug and alcohol programs lose funding.
Cambria County's service helped 556 unique clients from July 1, 2023, to June 30, 2024, providing assistance that ranged from inpatient detox management and outpatient maintenance to treatment and rehabilitation. That added up to more than $1 million for that year.
Patient concerns
Jeanne Spencer, Conemaugh Family Medical Clinic program director, said several of her patients have shared their concerns about uncertainty regarding the future of Medicaid and Medicare.
'They're worried that their benefits are going to decrease,' she said. 'Everything's in flux. News changes from hour to hour. These are people's lives and they don't know.'
A majority of the patients at the Conemaugh clinic rely on Medicaid and Medicare, Spencer said.
'The family medical center really focuses on an indigent population, and it's been really good for the working poor in our community,' she said.
With the potential for cuts, Spencer is worried people will choose not to seek care because they can't afford it.
Stratta said he's already seen a lot of people at the Hyndman clinics who have end-stage disease symptoms that, if they were seen earlier, could have prevented those issues, such as diabetes and hypertension.
Other preventable concerns that Hyndman is attempting to address include dental care. The clinic is one of two in Cambria County that takes Medicaid, which coupled with transportation barriers creates a dental desert in Cambria County, Stratta said.
That's where the provider's mobile unit has been handy since 2021. Staff are able to take dental care to patients, including check-ups, fillings and extractions.
Stratta said the unit goes to a lot of schools and community centers and the offering is expanding in Bedford County, with a waitlist to the end of 2026.
'We're there trying to provide that service they desperately need,' Stratta said.
Spencer advocated for people to reach out to their elected officials to address these matters.
'As people learn more about how this affects them, I think it's important to speak to the legislators and tell them how it is on the ground,' she said.