Federally-funded community health centers in the two dozen states that declined to expand Medicaid eligibility under the Affordable Care Act, will likely face financial struggles.
Those clinics may miss out on an estimated $569 million in additional revenue from Medicaid, Kaiser Health News reported. Medicaid expansion provided some $2.1 billion in additional revenue this year to the clinics in states that expanded eligibility, according to a study from George Washington University.
As a result, many of those clinics in states that didn't expand Medicaid won't have the liquidity to grow their staff and capacity. Furthermore, they may wind up stifling access to care among those who lack insurance coverage altogether.
"These low-income patients already face significant challenges to obtaining healthcare," Peter Shin, director of the Geiger Gibson Program in Community Health Policy at George Washington University, told KHN. "Our analysis suggests these patients will remain without access to affordable insurance, which will almost certainly lead to delays in care and the risk of more serious health conditions."
Altogether, federally-funded community health centers provide primary care to 21 million patients at 8,000 sites nationwide. Only about a quarter of those patients have some form of private insurance; the remainder are about evenly split between uninsured patients and Medicaid enrollees, according to KHN.
Community clinics face another issue in states that use so-called "private options" to expand Medicaid through commercial health plans. Those plans tend to pay clinics at rates far lower than traditional Medicaid arrangements.
Nationwide Medicaid expansion would have provided coverage to about 5.2 million clinic patients in total, according to the article.