Community health centers have been providing crucial health care services to Americans living in deep poverty for more than 50 years. Health centers now have more than 10,000 sites in rural and underserved communities in U.S. states and territories. However, proposed changes to the federal Medicaid program may impact the centers’ ability to continue to serve close to 26 million people who turn to them for health care.
“For many Americans, particularly women and children, community health centers serve as a medical safety net,” says Anne R. Markus, an associate professor in the Milken Institute School of Public Health’s (Milken Institute SPH) Department of Health Policy and Management. She has secured a $73 thousand grant from the Robert Wood Johnson Foundation to test a model that will simulate the federal and state changes designed to transform the Medicaid program, and then estimate the impact on health center revenue and capacity.
The research group will also conduct additional analyses to look at recent state proposals that aim to change the Medicaid program through Section 1115 or Section 1332 waivers or a combination of the two. Numerous states have approved/pending Section 1115 waiver requests, many of which would impose strategies to promote personal responsibility and community engagement, such as work requirements, healthy behavior incentives, and health savings accounts.
The project augments the considerable research portfolio of the Geiger Gibson Program in Community Health Policy, which is supported by a generous gift from the RCHN Community Health Foundation. “Investments in the Medicaid program, and in health centers, are essential to preserve and ensure the health of America’s underserved urban and rural communities. This study will help position the debate on the future of Medicaid.” Dr. Feygele Jacobs, RCHN Community Health Foundation President and CEO, said.
“It is important to conduct the proposed research in anticipation of major changes to come from both the federal and state levels,” Markus says. “Congress is currently considering changes that would significantly reduce federal financing to Medicaid, which has been an open-ended federal entitlement program since its inception.”
The project is being funded as part of the Robert Wood Johnson Foundation’s “Research in Transforming Health and Health Care Systems” program, which seeks to build the evidence base on the potential effects of policies or policy changes intended to transform health.