News Release 10-Jul-2019

Many still uninsured after Affordable Care Act Implementation

Following uninsured patients through Medicaid expansion: Ambulatory care use and diagnosed conditions

American Academy of Family Physicians


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In community health centers in Medicaid expansion states, among established patients who were uninsured prior to the Affordable Care Act, many remained uninsured after implementation of the Obama-era law. Using electronic health record data across 11 Medicaid expansion states, an Oregon Health & Science University study tracking uninsured patients before and after the implementation of the ACA found that 21% of those patients remained continuously uninsured, 15% gained Medicaid, 12% gained other insurance, and 51% did not visit their Community Health Center post ACA implementation. The 21% who remained uninsured were largely Hispanic and spoke Spanish as their primary language, indicating both a language and potential legal barrier to enrollment in the ACA. These uninsured patients continued to have frequent healthcare visits and the majority had at least one health condition that would require continuous care. The results of this study point to a need for additional funding to support the needs of Community Health Centers serving the uninsured.