What the Sequester means to the National Health Service Corps

More than 250,000 people won’t have access to care in their community because of the broad cuts to federal programs known as the “sequester.”  The sequester lead to a $15 million cut in the National Health Service Corps (NHSC) funding, reducing the number of recent awards made for those seeking to work in the underserved areas of our country.

Let’s start with how the sequester came to be. In 2011, Congress passed a law saying that if they couldn’t agree on a plan to reduce our deficit by $4 trillion there would be automatic across-the-board cuts – totaling $1 trillion – that would take effect in 2013. It was assumed that this threat would be so unpalatable to both Republicans and Democrats they would be forced to reach a negotiated compromise.  In the end, and now unsurprisingly, no deal was reached and the “unpalatable cuts” are now law.

The cuts under sequestration have seriously affected all Americans, but especially those who are already at-risk or underserved. In 2013, the NHSC received more than 5,700 applications from primary care providers looking to serve in federally designated Health Professional Shortage Areas (HPSAs). As is the case every year, awards are made starting with applications from the highest need HPSAs and continuing down the list as far as the funding allowed.  Unfortunately, due to the sequester cuts, only 2,130 awards were made and these were limited to sites with HPSA scores of 15 or above— the highest cutoff score in the history of the program.  Without the cuts imposed by sequester, the NHSC could have funded many of the applicants with HPSA scores of 14, but were unable to this year. This means:

If you applied for a NHSC award in an area with a HPSA score of 14, you did not get your award because of the sequester.

Right now, Congress is negotiating the 2014 Budget; leaders from the House and Senate are meeting to determine if they will replace sequester next year.  Each day Congress prolongs the sequestration cuts, millions of our most disadvantaged citizens are being denied the care they so desperately require. Let’s hope their fate is not a cautionary tale for what happens when our government cannot work together.