Geiger Gibson / RCHN Community Health Foundation Research Collaborative, issuing body.
Geiger Gibson Program in Community Health Policy, issuing body.
George Washington University, issuing body.
Milken Institute School of Public Health. Department of Health Policy and Management, issuing body.
[Washington, D.C.] : Milken Institute School of Public Health, George Washington University, November 18, 2013
The implementation of the Affordable Care Act (ACA), which includes both the creation of the new health insurance marketplaces (exchanges) as well as state Medicaid expansions, will expand health insurance coverage for millions of Americans. A related policy challenge is to ensure that the capacity of the health care system is sufficient to care for both the newly insured, as well as those who remain uninsured. Analyses indicate that the nation could face a shortfall of primary care providers in coming years, due to overall population growth, aging of the Baby Boomers and the health insurance expansions. Most health experts believe that expanding access to affordable primary and preventive health care is particularly vital. After Massachusetts expanded health coverage several years ago, community health centers and safety net hospitals became even more important as sources of ambulatory care. The status of the health care safety net will affect patients' ability to obtain the primary care they need. This brief analyzes the effect of federal and state policy decisions on the capacity of community health centers to meet future health care needs. It focuses on two particularly important policy issues: (1) the level of federal grant funding for community health centers and (2) whether states expand Medicaid coverage. This paper estimates the number of patients who could be served in health centers in 2014 and 2020, depending on the outcome of these federal and state policy decisions. Both higher federal grant funding and more state Medicaid expansions strengthen the capacity of health centers to offer primary care (as well as related services such as behavioral and dental care) to needy patients in medically underserved areas. With sufficient support from both sources, health centers could come close to doubling their capacity for patient care by 2020, but these findings indicate that ability of health centers to expand and meet their communities' needs could be curtailed by the failure of some states to expand Medicaid and inadequate federal funding support.
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