Nearly five million low-income Americans do not have access to affordable insurance because state legislators in 24 states refuse to expand Medicaid. A new report released last week gives a picture of some of the most vulnerable uninsured.

Of those low-income Americans who depend on community health centers for care, over one million people still lack health insurance coverage because of state refusal to expand Medicaid under the Affordable Care ActCommunity health centers receive federal funding to operate in communities that are medically under-served and typically poorer than the overall uninsured population. 71 percent of the people who depend on community health centers live in just 11 southern states, and people of color are disproportionately impacted by disparities in care.

“These low-income patients, many of them living in the South, already face significant challenges to obtaining health care,” said Dr. Peter Shin, the lead author of the study and director of George Washington University’s Geiger Gibson Program in Community Health. “Our analysis suggests these patients will remain without access to affordable insurance, which will almost certainly lead to delays in care and the risk of more serious health conditions.”

In contrast, community health centers in states that have expanded Medicaid have seen 2.9 million patients gain health coverage in 2014.

Researchers determined that community health centers in states that refuse Medicaid expansion will ultimately forgo $569 million in revenues. Some centers have already been forced to close due to lack of funding and patients – further limiting access to health care for people who depend on them. “In addition to forgoing the major gains in overall cost savings from greater access to preventive services, these states will also forgo gains in job creation, labor income and productivity, and related tax revenues,” the report states.

Some 3 million individuals enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) between October 2013 and the end of February. There is no deadline for states to opt into the Medicaid expansion.

Media Resources: George Washington University Milken School of Public Health; ThinkProgress 5/13/14; US Department of Health & Human Services 4/4/14; Kaiser Family Foundation 4/2/14; Feminist Majority Foundation

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