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Community Health Centers: A 2012 Profile and Spotlight on Implications of State Medicaid Expansion Decisions

Community health centers are an integral part of the health care safety-net, providing access to care for over 21 million people in the U.S. The ACA made a major investment in the health center program, and expanded health coverage will provide new revenues to health centers, permitting grant funding to support care of the uninsured to go further. This annual update provides a pre-ACA snapshot of community health centers and also examines newly reported data on “look-alike” health centers. In addition, the brief highlights significant differences between the profiles and revenue situations of health centers in Medicaid expansion and non-expansion states in 2012, before the ACA coverage expansions took effect. Finally, it considers financial challenges facing health centers and the implications of state Medicaid decisions for health centers and their capacity to ensure access to care for low-income communities they serve.

Medicaid Expansion in Michigan

This fact sheet describes Michigan’s 1115 waiver demonstration project, Healthy Michigan, which expands the State’s Medicaid program under the Affordable Care Act (ACA).

How Will the Uninsured in Pennsylvania Fare Under the Affordable Care Act?

This state report explains how the ACA expands coverage in Pennsylvania, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Pennsylvania are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

Profiles of Medicaid Outreach and Enrollment Strategies: The Cook County Early Expansion Initiative

The brief provides an overview of the Cook County, Illinois “CountyCare” early expansion waiver experience, which may help inform continued efforts as the Medicaid expansion is implemented across states. It finds that, in just over 12 months, more than 82,000 Cook County residents successfully enrolled in CountyCare coverage, allowing the state and county to get a significant jump start on the Medicaid expansion. Illinois implemented the full Medicaid expansion in January 2014 and automatically transitioned CountyCare enrollees to the expansion. As of March 2014, CountyCare members account for nearly half of the total statewide enrollment of adults into the Medicaid expansion.

Medicaid Expansion Through Premium Assistance: Arkansas, Iowa, and Pennsylvania’s Proposals Compared

Arkansas, Iowa, and Pennsylvania have proposed implementing the Affordable Care Act’s (ACA’s) Medicaid expansion by using Medicaid funds as premium assistance to purchase coverage for some or all newly eligible Medicaid beneficiaries in Marketplace (formerly called Exchange) Qualified Health Plans (QHPs). Arkansas and Iowa’s § 1115 demonstration waivers have been approved by the Centers for Medicare and Medicaid Services (CMS), and Pennsylvania’s application is pending with CMS. This fact sheet compares the states’ proposals.

An Overview of Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) Grants

This brief provides an overview of the Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) grants and highlights key findings from the interim evaluation of the program. The brief also places these grants in context of pre-Affordable Care Act (ACA) Medicaid beneficiary incentive programs and proposed programs of states that are incorporating healthy behavior incentives into Medicaid expansion waivers.