New report offers first nationwide look at the impact of the ACA on medically underserved

A new report examining newly-released data from the 2014 Uniform Data System (UDS), which collects patient and health care information from the nation's community health centers, shows how the Affordable Care Act (ACA) is changing insurance coverage and health care in the nation's most medically underserved urban and rural communities. Examining data collected from nearly 1,300 federally funded health centers operating in over 9,000 locations, the report shows that between 2013 and 2014, the number of health center patients with health insurance rose by more than 2.3 million (a 17 percent increase), the number of uninsured patients declined by 1.2 million (a 16 percent decrease), and the total number of patients served rose by over 1.1 million, (a 5 percent increase). Since 1996, the total number of patients served at federally funded health centers has nearly tripled, from slightly more than 8 million to almost 22.9 million patients served by 2014. The report, produced by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, which is based at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University, offers the first glimpse of how health centers are impacting access in the first full year of federal health reform.

The major growth in insurance coverage is largely explained by the ACA's Medicaid expansion, given the deep impoverishment of health center patients. Medicaid accounted for approximately 79 percent (1.8 million) of the 2.3 million increase in insured patients served by health centers. At the same time, the number of privately insured health center patients also rose from 3.1 to 3.6 million, an increase of 16 percent and by far the greatest increase in private insurance coverage over the 1996-2014 time period. Given health center patients' historically limited access to employer-sponsored coverage, the report concludes that this increase can be attributed to the affordable private health insurance made available through the health insurance Marketplace.

"Our findings underscore the importance of the Affordable Care Act to the poorest Americans," said Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at Milken Institute SPH and a study co-author. "This report shows the importance of ensuring that the ACA's resources reach all medically underserved communities, including those in the 20 states that have not yet expanded Medicaid."

Feygele Jacobs, President and CEO of the RCHN Community Health Foundation said, "Community health centers not only are critical providers for their patients but offer a crucial window into communities most in need of the health system transformation that comes from the health reforms embodied in the ACA."

"Since 1965, health centers have continued to play an important role in serving those who fall into the coverage gap," said Peter Shin, PhD, Director of the Geiger Gibson RCHN Community Health Foundation Research Collaborative and co-author of the report. "The recent uptick in newly-insured patients shows health centers are just as important for those gaining coverage."

Source: George Washington University Milken Institute School of Public Health