The sliding scale fees are useful in health centers such as FQHCs and Look-Alikes. According to the law, the charges by FQHCs on individuals with the incomes level that are below the Federal Poverty Level should not exceed the nominal fee (Erwin, et al., 2016). FQHCs should use the sliding fee scale with a discount when charging individuals with incomes ranging between 101% and 200% of the FPL (Erwin, et al., 2016). Moreover, the discounts given depends on the income and the family size of the patient. The funding for this program comes from the Health Resource and Services Administration. The grants serve the entire community while other are meant for a particular population.

Medicaid HMOs and Medicaid PPACA patients impact the FQHC in the following manner. First, there will be expansion in insurance coverage. All children and adults with lower incomes not exceeding the 133% of the FPL will enjoy extended Medicaid under the PPACA thus increasing their insurance coverage (Erwin, et al., 2016). The second impact is increased funding. According to Erwin, et al., (2016), HMOs and PPACA will have to allocate more funds to expand and improve existing centers. This will increase the number of patients that FQHCs can accommodate. In areas with less primary care providers, the funding will help in balancing the patient-nurse ratio by increasing nurses, dentists, and other health professionals.

Part 2
The law requires that individuals with incomes that are below the Federal Poverty Level should not be charged a fee that is more than the nominal fee. FQHCs may charge individuals with incomes ranging from 101% to 200% FPL using the sliding fee scale (Stanhope & Lancaster, 2016). These individuals are given discounts depending on the size of their family and level of income. The Health Resource and Services Administration (HRSA) funds this program. The grants funded are mostly for the entire community or specific population. For instance, the HRSA may target immigrants or homelessness.

The impact of Medicaid HMOs patients on the FQHC include an increase in the activity of the physicians. Physicians tend to find ways they can share risks and costs due to attending to low-income population (Adams & Herring, 2008). Regarding the Medicaid PPACA patients, the impact on FQHCs includes increased funding. Over the next five years, PPACA will have to allocate approximately $11 billion to increase the number of patients it can accommodate. The second impact is insurance expansion. Due to the expansion of insurance, a small percentage of FQHC patients will be uninsured.

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