The Affordable Care Act Medicaid Expansion Positively Impacted Community Health Centers and Their Patients
The Affordable Care Act Medicaid Expansion Positively Impacted Community Health Centers and Their Patients
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DOI：
10.1007/s11606-019-05571-w
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发表时间：
2020-01-02
影响因子：
5.7
通讯作者：
Angier, Heather
中科院分区：
文献类型：
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作者：
Tilhou, Alyssa Shell;Huguet, Nathalie;Angier, Heather
社区卫生中心 (CHC) 为服务不足的儿童和成人提供初级保健。 《患者保护和平价医疗法案》(ACA) 旨在通过增加联邦资金和扩大医疗补助资格来加强 CHC 网络。 ACA 还旨在加强预防和心理健康服务，并减少健康和医疗保健差距。在此，我们总结了作为专家迄今为止调查 ACA 医疗补助扩张对 CHC 及其服务的患者影响的结果。我们发现 ACA 医疗补助扩张增加了获得护理和预防服务的机会，主要是在医疗补助扩张州。在扩张状态下，从 ACA 实施前到 ACA 实施后，身心健康状况的发生率大幅上升，这表明 ACA 实施前诊断不足。 CHC 中按种族/族裔划分的健康保险覆盖范围差异有所缩小，但仍有一些差异。这些发现表明，ACA 医疗补助计划的扩展极大地帮助了 CHC 和患者。保险范围的扩大通过增加报销提高了社区健康中心的财务生存能力。因此，ACA 医疗补助计划的扩展增强了服务不足的患者的健康状况，而废除该计划将危及 CHC 及其患者的这些进步。
Community health centers (CHCs) provide primary care for underserved children and adults. The Patient Protection and Affordable Care Act (ACA) aimed to strengthen the CHC network by increasing federal funds and expanding Medicaid eligibility. The ACA also aimed to boost preventive and mental health services and to reduce health and healthcare disparities. Here, we summarize our results to-date as experts in investigating the impact of ACA Medicaid expansion on CHCs and the patients they serve. We found the ACA Medicaid expansion increased access to care and preventive services, primarily in Medicaid expansion states. Rates of physical and mental health conditions rose substantially from pre- to post-ACA in expansion states, suggesting underdiagnosis pre-ACA. Disparities in health insurance coverage by race/ethnicity decreased at CHCs, yet some remain. These findings indicate that the ACA Medicaid expansion significantly helped CHCs and patients. Insurance expansion buoyed CHCs' financial viability by increasing reimbursement. Therefore, the ACA Medicaid expansion enhanced the health of underserved patients and repeal would jeopardize these advances for CHCs and their patients.