Affordable Care Act trend analysis: Michigan’s safety net providers and clients

September 14, 2015

A stethoscope pressed against the screen.

This brief looks at trends between 2008 and 2014 with regard to Michigan federally qualified health centers (FQHCs) and free clinics. We find that more Michigan patients are receiving care at FQHCs and some free clinics are converting to FQHCs.

In 2014, the Affordable Care Act’s (ACA) major coverage expansions—the individual health insurance marketplace and Medicaid expansion—significantly altered the health care landscape.

In Michigan, more than 340,000 Michigan residents selected a marketplace plan by March 2015, and as of August 2015, approximately 606,000 Michigan residents had enrolled in the Healthy Michigan Plan, Michigan’s Medicaid expansion program. As a result of the ACA’s coverage expansions, Michigan’s uninsured rate decreased from 11 percent in 2013 to approximately 8 percent in 2014.

Key findings include:

  • Between 2013 and 2014, Michigan experienced significant growth in the number of FQHC delivery sites, from 164 to 220. During this time, the number of free clinics in Michigan decreased from 73 to 71.
  • Between 2013 and 2014, the number of total patients who received care at Michigan FQHCs increased by 7 percent to approximately 600,000 patients.
  • The number of patients seeking mental health services increased by 67 percent since 2008, stabilizing between 2013 and 2014. In 2014, nearly 26,000 patients were served.
  • Between 2013 and 2014, the number of Medicaid patients served by FQHCs increased by 24 percent, from 250,000 to more than 308,000 patients; and, the number of privately insured patients increased by 28 percent, from 78,000 to nearly 100,000 patients.
  • In 2014, approximately 125,000 FQHC patients in Michigan (21 percent) were uninsured, a 28 percent decline from 2013.
  • In response to the ACA’s coverage expansions, some free clinics are changing their structure or service scope, including converting to an FQHC or adopting new policies to serve underinsured or Medicaid patients while continuing to see uninsured patients.

Editor’s Note: Counts for FQHC delivery sites in 2013 were updated to reflect the total number of permanent, seasonal, and administrative/service delivery sites in operation.