Original ArticlesThe Self-Sustainability of Federally Qualified Health Centers Examining the Impact of Medicaid ExpansionDavlyatov, Ganisher PhD; Hiller, Sidney MHA; Cendoma, Philip MHA; Borkowski, Nancy DBA, FACHE, FHFMA Author Information Department of Health Administration and Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City (Dr Davlyatov and Ms Hiller); and Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham (Mr Cendoma and Dr Borkowski). Correspondence: Ganisher Davlyatov, PhD, Department of Health Administration and Policy, Hudson School of Public Health, University of Oklahoma Health Sciences Center, 801 Northeast 13th St, Oklahoma City, OK 73126 ([email protected]). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.ambulatorycaremanagement.com). Journal of Ambulatory Care Management: January/March 2023 - Volume 46 - Issue 1 - p 12-19 doi: 10.1097/JAC.0000000000000441 Buy SDC Metrics Abstract States' decisions to expand Medicaid eligibility would make most low-income uninsured people eligible for Medicaid, while also increasing the financial viability of Federally Qualified Health Centers (FQHCs) by reducing their grant to total revenue ratios. We extracted a national sample of 729 FQHCs for the period 2009 to 2018. The dependent variable was grant to revenue ratio and the independent variable was the states' Medicaid expansion status. FQHCs operating in Medicaid expansion states had lower grant ratios during the postexpansion period. As past decades' funding volatilities have shown, overreliance on one revenue source may increase financial risk. Medicaid expansion can support FQHCs by improving their long-term financial sustainability. © 2022 Wolters Kluwer Health, Inc. All rights reserved.