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Community Health Centers May Suffer in Medicaid Opt-Out States

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By Phil Cohen

Community health centers and their patients will suffer from a double whammy in states that refused Medicaid expansion, according to a study by RCHN.

Federally-funded community health centers serve nearly 21 million patients nationwide; just over 2 million of those patients live in the 24 states that refused Medicaid expansion. Though 1.2 million patients qualify for subsidized insurance in the ACA healthcare marketplaces, 1.1 million more patients fall into the “coverage gap” between standard Medicaid eligibility and income requirements to receive a subsidy for insurance. These patients will likely have little access to specialists and other services not provided by the community health centers, at least not without paying a substantial out-of-pocket cost.

At the same time, the community health centers in opt-out states will miss out on $569 million in additional revenue they would have received from expanded Medicaid programs. The lost funding opportunity will make it difficult for centers to hire healthcare providers and expand their services, stunting their growth and aggravating established problems with accessibility in underserved areas. To contrast, community health centers in states that chose to expand their Medicaid programs are projected to receive more than $2 billion in increased revenue.

This report comes on the heels of reports that other healthcare systems in opt-out states are seeing higher numbers of uninsured admissions and self-pay ER visits.

Health care facilities in opt-out states may find it more difficult to secure working capital, whether due to a lack of federal funding or an increase in self-pay invoices. If your health care company needs funding support, contact PRN Funding to learn more about your healthcare factoring options.

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Phil Cohen

About the author

Philip Cohen is the founder and President of PRN Funding, LLC. PRN Funding is an extraordinarily focused niche player in healthcare funding. With years of…... Read More

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