When the Affordable Care Act was created, the design included expanding cost-effective primary care through community health centers. In North Carolina, half of health center patients are uninsured. These centers rely on federal grants to support care for that population.
The ACA planned to establish additional health center sites to serve the newly insured through expanded Medicaid and the private health insurance marketplace. These sites, developed with time-limited federal funding, would later be sustained as more uninsured received coverage.
After passage of the ACA, the U.S. Supreme Court decided to allow states to opt out of Medicaid expansion, upsetting the delicate funding model. The N.C. General Assembly’s election of this option is threatening the sustainability of health centers.
We anticipate 70 percent of federal grant funding will run out in 2016, and Medicaid for childless adults is not there to make up the difference. More than half of individuals whomhealth center outreach workers encounter make too little for private insurance through the ACA marketplace and receive uncompensated care because Medicaid is not available. Now, access to care for all health center patients is at risk.
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The medical homes of 477,000 people in North Carolina depend on our legislature’s change of heart.
CEO, N.C. Community Health Center Association