A new policy brief by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the Milken Institute School of Public Health presents an analysis of the potential far-reaching consequences of approved §1115 Medicaid work experiment programs on community health centers and the patients they serve in seven states. Building on estimates of coverage losses among Medicaid beneficiaries subject to work experiments, prepared by GWSPH colleagues Leighton Ku and Erin Brantley for the Commonwealth Fund, the new brief presents estimates of the potential impact of Medicaid work experiments on beneficiaries who are patients of health centers, and ultimately, the implications for health centers and the wider communities they serve. It offers first-time estimates of the impact of Medicaid work experiments on community health center patients, revenue, and staffing in Arizona, Indiana, Ohio and Michigan, as well as updated estimates for Arkansas; it also includes estimates reported earlier for both Kentucky and New Hampshire.
Authors Jessica Sharac, Peter Shin and Sara Rosenbaum estimate that 120,000 to 169,000 adult Medicaid health center patients in these states are at risk of losing coverage. As a result of declining Medicaid coverage, health centers would experience a deep reduction in Medicaid revenue, ranging from one percent of total revenue on the low end to ten per cent on the high end, or an estimated $89 million to $125 million in patient care revenue across all seven states. As a result, health centers would be forced to reduce staff by 815 to 1,145 full-time equivalent staff members, and consequently, would serve fewer patients. Overall, it is expected that 104,000 to 147,000 health center patients in these states could lose access to care.
Just as the expansion of health insurance led to overall community and system-wide economic benefits, coverage losses can lead to system-wide reductions in services and access that adversely impact care for all. The widespread adoption of Medicaid work requirements would thus have substantial and long-term spillover effects, dramatically increasing the number of people who are uninsured and, as a result, substantially reducing health center revenue and threatening access to care across entire communities.
REMINDER: Respond to the 2019 Survey of Community Health Centers
A survey in field needs your input! This survey looks at: 1) The impact on community health centers of recent or pending policy changes, including Medicaid work requirements and policies affecting immigrant families; 2) how health centers are responding to the opioid crisis; and 3) the financial and patient care-related challenges health centers face. It is being conducted by the Geiger Gibson Program in Community Health Policy at the Milken Institute SPH, GWU in partnership with the National Association of Community Health Centers (NACHC), the Kaiser Family Foundation (KFF), and the RCHN Community Health Foundation. You may submit your health center’s response using this direct link to the survey.