The Affordable Care Act Medicaid Expansion Positively Impacted Community Health Centers and Their Patients

Alyssa Shell Tilhou 1 2, Nathalie Huguet 3, Jennifer DeVoe 3, Heather Angier 3

Affiliations

PMID: 31898120
PMCID: PMC7174462 (available on 2021-04-01)
DOI: 10.1007/s11606-019-05571-w

Abstract

Community health centers (CHCs) provide primary care for underserved children and adults. The Patient Protection and Affordable Care Act (ACA) aimed to strengthen the CHC network by increasing federal funds and expanding Medicaid eligibility. The ACA also aimed to boost preventive and mental health services and to reduce health and healthcare disparities. Here, we summarize our results to-date as experts in investigating the impact of ACA Medicaid expansion on CHCs and the patients they serve. We found the ACA Medicaid expansion increased access to care and preventive services, primarily in Medicaid expansion states. Rates of physical and mental health conditions rose substantially from pre- to post-ACA in expansion states, suggesting underdiagnosis pre-ACA. Disparities in health insurance coverage by race/ethnicity decreased at CHCs, yet some remain. These findings indicate that the ACA Medicaid expansion significantly helped CHCs and patients. Insurance expansion buoyed CHCs' financial viability by increasing reimbursement. Therefore, the ACA Medicaid expansion enhanced the health of underserved patients and repeal would jeopardize these advances for CHCs and their patients.

Keywords: Patient Protection and Affordable Care Act; community health centers; health care reform; healthcare disparities; uninsured.