A new report by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services examines the impact of health reform on community health centers (CHCs) and their patients. The study estimates that more than five million health center patients would have gained coverage had all states participated in a sweeping Medicaid expansion. However, nearly half of all CHCs are located in states that have opted out of the expansion. As a result, more than a million uninsured CHC patients who would have been covered under a nationwide Medicaid expansion will be left without the protection of health insurance, according to the report.
Lead author Dr. Peter Shin, director of the Geiger Gibson Program in Community Health Policy and an associate professor of health policy at the School of Public Health and Health Services, and his colleagues analyzed data from both the 2009 Health Center User Survey and the 2011 Uniform Data System to gauge the impact of the Affordable Care Act on health center patients nationally and in all 50 states and the District of Columbia.
The bottom line for the 518 health centers located in the opt-out states: researchers found the CHCs will forgo approximately $555 million they would have received had their states expanded Medicaid, yet they will still be treating all community residents, including those who lack health insurance or the means to pay for care. Additionally, the poor living in the 25 opt-out states will continue to lack coverage and might find long wait times at clinics, long distances to find care, and other barriers that could translate to delays in treatment or no care at all.
“Community health centers represent the backbone of the nation’s safety net, providing high quality care to more than 20 million Americans who live in underserved neighborhoods,” says Ms. Feygele Jacobs, president and CEO of the RCHN Community Health Foundation. “Without the Medicaid expansion, CHCs in opt-out states will fall behind and will have trouble providing the kind of care that keeps people and communities healthy.”