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Health Insurance & Affordable Care Act

States’ Medicaid Decisions Leave Health Centers, Patients In Lurch

WebMD News from Kaiser Health News

By Phil Galewitz

Fri, May 09 2014

More than 1 million patients who use federally funded community health centers will remain uninsured because they live in one of 24 states that chose not to expand Medicaid under the Affordable Care Act, according to a study released Friday by researchers at George Washington University.

Most of those patients live in the South, because every state in that region except Arkansas and Kentucky opted against expanding the federal-state program for the poor after the Supreme Court ruled in 2012 that it was optional.

“These low-income patients already face significant challenges to obtaining health care,” says lead author Peter Shin, director of the Geiger Gibson Program in Community Health Policy at George Washington University. “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.”

Health centers in states that have expanded Medicaid are benefiting, as 2.9 million of their uninsured patients were projected to gain coverage in 2014 either through Medicaid or through buying subsidized private coverage on the new health insurance marketplaces, the report found. Officials at health centers in Colorado, Kentucky and other states that expanded Medicaid have seen their rates of uninsured patients fall dramatically this year.

Gaining coverage helps health center patients get access to specialists along with prescription drugs, diagnostic tests and hospital care for little or no out-of-pocket costs. The coverage will also be a financial bonanza for health centers that are paid several times more from Medicaid than from the sliding scale fees they charge the uninsured.

Nationally, about 1,200 community health centers provide primary care services to nearly 21 million patients at 8,000 sites. About 36 percent of their patients in 2012 were uninsured and 39 percent were on Medicaid.

In the states that expanded Medicaid this year, the government and private insurance payments will generate potential revenues of $2.1 billion in 2014 for the centers. That’s money the centers can use to pay for physicians, nurses and to expand services. But in the states that opted against expanding Medicaid, the centers will lose about $569 million in extra Medicaid funding, the study found.

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