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.
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health