Community health center utilization following the 2008 medicaid expansion in Oregon: Implications for the affordable care act

Brigit Hatch, Steffani Bailey, Stuart Cowburn, Miguel Marino, Heather Angier, Jennifer Devoe

Research output: Contribution to journalArticle

8 Scopus citations


Objectives. To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment). Methods.Weconducted a retrospective cohort studywith electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those whomaintained (n = 788) or lost (n = 944) insurance coverage.We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions. Individuals who maintained coverage through Oregon's Medicaid expansion increased long-termutilization of CHCs,whereas thosewithunstable coverage did not. Policy implications. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.

Original languageEnglish (US)
Pages (from-to)645-650
Number of pages6
JournalAmerican Journal of Public Health
Issue number4
StatePublished - Apr 1 2016


ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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