Part of the Patient Protection and Affordable Care Act (ACA) was designed to extend public health care coverage to millions of Americans and will provide states with a fiscal cushion to help achieve that goal. What have largely gone unnoticed however, are the economic development benefits of the Act. The ACA provides sub- stantial funding for the creation of new community health centers in medically under- served areas in order to serve this new patient population. Other provisions of the Act offer a host of economic benefits via a variety of related community economic development funding opportunities. The intent of this article is to provide a review of the literature regarding the importance of the ACA for community economic development. Subsequently, we provide two case studies as examples that illustrate the initial impacts of the ACA. We conclude that those states that choose not to expand public health care coverage to low-income populations will forego more than just Medicaid matching funds. State and local governments also stand to lose out on substantial economic development dollars.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.