Submitted on Tue, 2014-06-03
By Alexander Parkinson

Community Health Centers in the 24 states that have opted out of Medicaid expansion are expected to lose $569 million in potential revenue this year.

24 States Opt Out of Medicaid Expansion

24 states have opted out of expanding Medicaid coverage and are putting their community health centers and citizens in a tough spot. More than one million patients will remain uninsured as a result and community health centers will miss out on collecting $569 million in new revenue.

Compare that to the 26 states that have opted into expanded Medicaid. More than 2.9 million newly insured patients will contribute an extra $2.1 billion in new revenue to community health centers.



71% of those affected live in the southern U.S. The biggest losers are by far the citizens and community health centers in Florida and Texas. More than a quarter-million people will remain uninsured without the Medicaid expansion and community health centers in those two states will miss out on almost $170 million in revenue (roughly $1.5 million per center). It’s absolutely vital that these community health centers get every resource possible to help their patients. In the fourteen largest states that are opting out of Medicaid expansion, there is expected to be an increase of more than $1 billion in uncompensated care costs.

Meanwhile, the 26 states that have opted into the expanded Medicaid coverage are going to experience a boom in revenues. California’s community health centers alone are expecting to see an increase of more than $330 million, New York’s health centers expect $85 million, and eight more states expect to see increases of more than $25 million each.

Having health insurance reduces the annual risk of death by 30%. This is an important statistic the states opting out of Medicaid expansion don’t seem to grasp. Those without insurance are more likely to skip doctor visits for preventive and primary care, making the attention they often need immediate and costly to perform. Without insurance, community health centers have to eat the cost themselves, hindering their ability to provide services to the rest of the population. Less revenue also means community health centers can be less competitive in the hiring market. They may not be able to lure top recruits to work for them and their own top employees may flee to the greener pastures in states that have expanded Medicaid.

Many of the 24 states that are opting out are in the bottom of the country’s health rankings and denying patients insurance coverage will not improve those numbers. Less money and less talent makes it very difficult to protect the health of everyone in their community. Luckily, these states can always opt into the expansion at anytime in the future to improve health outcomes in their state.


Our SMART Health Claims management system enables community health centers and local health departments to create sustainable revenue by building/optimizing billing programs to maximize reimbursements from Medicaid, Medicare, and private insurance plans. Schedule a meeting with our claims management experts today to review your processes to make sure you are capturing the revenue necessary to keep your organization financially stable.

About the Author

Alexander is a Healthcare Analyst for Upp Technology's Public Health Divisin, SMART Health Claims. He graduated from Wesleyan University and is passionate about improving public health, fitness, and community wellness. You can contact Alexander at

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