For Immediate Release: March 10, 2020
Affordable Care Act Strengthened Community Health Centers Nationwide But Progress Must Be Sustained, Analysis Concludes
WASHINGTON, D.C. and NEW YORK, N.Y. (March 10, 2020) – The Affordable Care Act (ACA), which marks its tenth anniversary this year, has facilitated the rapid growth of community health centers, allowing them to reach millions of new patients nationwide. This expansion of accessible, community based health care represents one of the law’s greatest achievements, concludes a new report produced by researchers at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health (Milken Institute SPH).
By expanding Medicaid, and establishing subsidized Marketplace plans, the ACA insured many of the poorest Americans, especially in those communities most likely to be served by health centers. The ACA also created a Community Health Center Fund to directly support new health center grantees, the addition of health center sites and the expansion of necessary health care services. Together, these policy reforms, and the additional resources for clinical staffing made available through the National Health Services Corps and Teaching Health Centers Graduate Medical Education program, have allowed the number of patients served by health centers to increase by nearly 46 percent over the last decade, from 19.5 million in 2010 to 28.4 million in 2018.
Community health centers located in Medicaid expansion states have experienced the most robust growth, and health centers in non-expansion states remain somewhat smaller and more dependent on grant funds overall. Still, the report’s authors find that health centers in all states have added new locations and expanded capacity. In addition, health centers have added new services, and now treat more patients with complex medical and behavioral health conditions, including HIV and substance use disorders.
“The Affordable Care Act ensured that the most vulnerable patients and communities would realize its benefits,” said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH, one of the authors of the report. “At a time when the future of the ACA itself is on the line in the courts and the nation is confronting a major public health crisis, community health centers have never been more important.”
With gains in staffing and capacity, health centers now serve one in 12 Americans, nearly one in five Medicaid and CHIP enrollees and one in five uninsured people. To sustain these achievements and meet future challenges, the report’s authors write, it is essential to address key coverage, funding and workforce factors: stabilizing Medicaid and marketplace availability; extending the ACA Medicaid expansion in all states; extending and stabilizing the Community Health Center Fund; and providing support for workforce recruitment and training that will be necessary to meet the needs of health center patients.
“Since their earliest days as a small demonstration program launched in 1965, community health centers have grown and flourished, expanding dramatically over the last 10 years to provide access to care for nearly 30 million people in high-need communities nationwide,” said Feygele Jacobs, DrPH, president and CEO of the RCHN Community Health Foundation. “To build on this success, and sustain these gains in access, care and quality, it’s essential that health centers have stable, permanent funding and support.”
The analysis, “Community Health Centers Ten Years After the Affordable Care Act: A Decade of Progress and the Challenges Ahead” was conducted by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative.
The Geiger Gibson Program in Community Health Policy, established in 2003 and named after human rights and health center pioneers Drs. H. Jack Geiger and Count Gibson, is part of the Milken Institute School of Public Health at The George Washington University.
The RCHN Community Health Foundation is the only foundation in the U.S. dedicated solely to community health centers. The Foundation’s gift to the Geiger Gibson program supports health center research and scholarship.
The Milken Institute School of Public Health at the George Washington University is the only school of public health in the nation’s capital.