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George Washington University, School of Public Health and Health Services, Department of Health Policy


Geiger Gibson/RCHN Community Health Foundation Research Collaborative Policy Research Brief No. 16


Medicaid & SCHIP; Health Care Costs; Safety Net; Health Information Exchange; Primary Care; Community Health Centers


This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including $105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases for federal health center grants and provide for the use of the prospective payment system for health center payments under health insurance exchange plans. However, it is important to note that, although both the Senate and House bills authorize increased health center appropriations up to certain levels, the House bill also creates a mandatory trust fund which can be tapped for health center appropriations, increasing the likelihood that actual appropriations would reach the levels authorized in the bills.

Open Access