By Emili LaBass
More than four years into implementation of the Affordable Care Act (ACA), community health centers continue to play a prominent role in connecting consumers with health coverage despite recent federal reductions in ACA advertising funding, diminishing support for navigators, and a shortened open enrollment period.
Community clinics and health centers provide comprehensive primary and preventive health care services to patients regardless of ability to pay, often serving as critical access points in low-income and underserved communities. For more information on the role of community health centers in California, see the ITUP Health Policy Essentials, California’s Health Care Safety Net.
A recent survey by the Kaiser Family Foundation(KFF)/Geiger Gibson Program (GGP) reveals that across the country community health centers are actively engaged in outreach and enrollment efforts under the ACA. In addition, ACA implementation supported expanded service capacity and improved financial stability.
The survey also revealed challenges faced by community health centers in other states in 2018 given the shorter federal open enrollment period and severe cutbacks in federal funding for outreach, marketing and enrollment support. The federal advertising budget dropped from $100 million to $10 million.
California Health Centers Grow Under ACA
Following the national trend, California’s community health centers played a pivotal role in helping consumers sign up for ACA coverage, including Medicaid (Medi-Cal in California) and were able to expand services and staffing. A 2017 report prepared by the California Primary Care Association (CPCA) shows an increase in consumer utilization across all provider types and significant growth in the overall number of community health centers in the state under ACA. In addition, CPCA reported increases in Medi-Cal revenues for community health centers which grew by 175 percent from 2010 to 2016.
Fortunately, California health centers did not face all the same challenges in enrolling consumers for the 2018 coverage year as health centers nationally. California extended the open enrollment period for the state exchange, Covered California, beyond the federal period by an additional six weeks, and allocated $111.5 million for marketing and outreach statewide. California continues to invest in preservation and advancement of coverage gains under the ACA which led to the significant drop in the uninsured from 13.8% in 2013 to 7.4% in 2016. Medi-Cal enrollment increased by nearly five million individuals in the same period.
The KFF/GGP survey highlighted how federal efforts to weaken the ACA mobilized community health centers across the U.S., including health centers in California, to redouble their enrollment efforts and support consumers in accessing health care and coverage. Going forward, community health centers can be expected to play a prominent role in enrolling individuals and families in health coverage at the local level and ensuring access to health care in communities most in need.