title: Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.
abstract: Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states.
authors.affiliation: Xinxin Han is a graduate research assistant in the Department of Health Policy and Management, Milken Institute School of Public Health, at George Washington University, in Washington, D.C.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Han
authors.affiliation: Qian Luo is a research associate in the Department of Health Policy and Management, Milken Institute School of Public Health, at George Washington University.
authors.forename: Qian
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Leighton Ku (lku@gwu.edu) is a professor in the Department of Health Policy and Management, Milken Institute School of Public Health, and director of the Center for Health Policy Research, both at George Washington University.
authors.forename: Leighton
authors.initials: L
authors.lastname: Ku
mesh_terms: D057191:Capacity Building / Q000191:economics*; D003151:Community Health Centers / Q000706:statistics & numerical data* / Q000639:trends; D004608:Eligibility Determination; D005381:Financing, Organized; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data / Q000639:trends; D007348:Insurance, Health / Q000706:statistics & numerical data / Q000639:trends; D008484:Medicaid / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence; D011203:Poverty; D011320:Primary Health Care / Q000191:economics; D014481:United States
keywords: Affordable Care Act; Community Health Centers; Health Services Utilization; Medicaid Expansion