The goal of this project is to inform the policy debate on the implications for states, providers, health centers and patients of potential changes to the Medicaid program. The researchers will test a model that will simulate the effect of proposed federal changes designed to transform the nature of the Medicaid program (e.g. block grants) on health centers’ revenues and capacity to serve medically underserved communities and Medicaid patients. Complementary state-focused policy analyses will examine state proposals currently in the works that aim to change the Medicaid program through Section 1115 or Section 1332 waivers or a combination thereof. Deliverables will include a project work plan and final narrative and financial reports. The grantee will also produce paper(s) suitable for publication and present findings at national research meetings and to other stakeholder audiences as appropriate, including policymakers at the federal, state, and local levels, as part of the deliverables for this grant.