January 18, 2017
Community health centers are the nation’s largest source of comprehensive primary care for medically underserved communities and populations. Under the Affordable Care Act (ACA), increased patient revenues due to the expansion of Medicaid and private health insurance, along with substantially increased direct federal investment in the program, led to growth in the number of health centers and their capacity to provide services. This brief from the Kaiser Family Foundation draws on 2015 federal data on health centers and a 2016 Survey of Health Centers’ Experiences and Activities under the Affordable Care Act to provide a snapshot of health centers and their patients, analyze recent changes, and compare the experience of health centers in Medicaid expansion and non-expansion states. This information is germane to the impending debate on the ACA and the potential impact of changes on coverage and access to care for low-income Americans and financing for safety-net providers. Among the key findings are that:
- Health centers are a core source of primary care in the U.S., particularly for Medicaid beneficiaries and uninsured people.
- Health center patients are increasingly insured, primarily due to the ACA Medicaid expansion.
- The Medicaid expansions strengthened health center finances and capacity.
- Health centers, particularly those in non-expansion states, report increased numbers of insured patients who are unable to pay their deductibles and cost-sharing.
- Federal grant funding remains essential to support health centers.
- If the ACA were repealed, ending the Medicaid expansion and the health center trust fund, health centers would be challenged to sustain their operations.
The report was authored by researchers at The Milken Institute School of Public Health at the George Washington University (GW) and the Kaiser Family Foundation with additional funding support from the RCHN Community Health Foundation.