Eligibility Assistance Increases Insurance Enrollment Within Community Health Centers But Not At The State Level.

Area of Science:

• Health Services Research
• Health Economics
• Public Health Policy

Background:

• Community health centers (CHCs) are known to reduce federal medical expenditures.
• Concerns exist that eligibility assistance services offered by CHCs may increase insurance enrollment and federal costs.
• Understanding the impact of these services is crucial for healthcare policy and resource allocation.

Purpose of the Study:

• To analyze the effects of eligibility assistance provided by CHC staff on insurance enrollment at both the health center and state levels.
• To determine if increased insurance enrollment due to eligibility assistance leads to higher federal costs.
• To assess the impact of eligibility assistance on the number of uninsured patients within CHCs.

Main Methods:

• Multivariate panel analysis with two-way fixed effects was employed.
• Data spanned the period 2016-2023.
• Utilized administrative data from CHCs and state-level enrollment data for Medicaid, Children's Health Insurance Program (CHIP), and health insurance Marketplaces.

Main Results:

• Higher eligibility assistance staffing correlated with modest increases in Medicaid and CHIP enrollment at CHCs.
• A modest reduction in uninsured patients was observed at CHCs with increased eligibility assistance.
• Eligibility assistance and CHC size did not significantly impact state-level enrollment across Medicaid, CHIP, or Marketplaces.

Conclusions:

• Eligibility assistance modestly enhances insurance coverage for CHC patients, improving financial status and care capacity.
• This assistance does not significantly increase overall state-level enrollment in public insurance programs or federal expenditures.
• CHCs play a role in increasing patient insurance coverage without substantially altering broader federal costs.