LAUSR

Community Health Centers (CHCs) provide primary care services to 26 million low-income patients annually, offering preventive services, chronic disease management services, and some mental health and substance abuse services to patients without regard for ability to pay. Despite experiencing substantial coverage gains following the Affordable Care Act (ACA), CHC patients continue to have high rates of uninsurance: in 2014, 23% of CHC patients in Medicaid expansion states and 39% of CHC patients in non-expansion states remainedwithout coverage. 1 Lack of insurance coverage among CHC patients may compromise access to important health services that are often not directly provided in CHCs, including specialty care, 2 prescription medications, 3 and behavioral health services. This in turn may lead to adverse health outcomes for these patients. Little is known about the role of health insurance in access to care for CHC patients, particularly regarding access to nonrequired services that are not always directly provided by CHCs. While pre-ACA and state-specific evidence suggests insurance is associated with better access to and quality of primary care for CHC patients, 4,5 no recent evidence exists. Thus, our objective was to estimate the association of having health insurance with access to care among CHC patients in 2014–2015.