6.4 million people have been enrolled in coverage through the federal insurance marketplace for 2015. Consequently, the nation’s uninsured rate has dropped to historic lows, especially in expansion states and these states are spending less on health care for their uninsured. Many Federally Qualified Health Centers (FQHC), for the first time, are experiencing competition for their patients who were previously uninsured. As they look to gain efficiencies and cut costs, there is no greater cost than labor.