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The Affordable Care Act and Free Medical Clinics

November 1, 2013

“Well there’s not gonna be much use for your clinic after everyone gets insurance with Obamacare”, said the concerned citizen, “at least you won’t cost the city so much money in funding, right?” I have never been knocked over by words, but this over zealous and mis-educated gentleman almost did it.  After collecting my thoughts I replied, “Well, there will still be uninsured residents of Miami County even after the full implementation of ACA sir, we plan to continue to serve them”, with a slight grin I added, “and we aren’t supported by your taxes.”

My new friend at the town hall meeting is right to make assumptions about the future of Health Partners, especially life after ACA.  Let’s face it, many folks would assume that if all citizens have healthcare insurance, then why would their remain uninsured to serve?  According to the National Association of Free & Charitable Clinics, one of the most common misconceptions about how the United States will look after the full implementation of ACA is that there will no longer be a need for Free and Charitable Clinics to continue to provide charity care as a member of the safety net.  In fact, many are surprised to hear that even after full implementation of the ACA, there may be as many as 26 million people who are still without access to health insurance

Free medical clinics have been lifesavers to thousands of people lacking health insurance these past few years during the run-up to the official start of expanded health insurance coverage under ACA.  The Affordable Care Act is supposed to provide insurance and a consistent doctor for many patients who currently rely on the roughly 1,200 free clinics around the country.  But even after the federal law is operating in full force, there may be many people who will still need free care for one reason or another.  The lesson from the State of Massachusetts, where a health coverage law has been in effect for five-and-a-half years, is, free medical clinics should plan to stay open.

With the enactment of the ACA there have come many questions about the dynamic changes that will take place in our health care system over the next decade.  Free clinics all over the state are doing their best to field some of these questions and concerns as they themselves continue to question and strategize for the future.  Here at Health Partners, we are asking ourselves these same questions as we prepare for the changes to come.  Information from the Ohio Department of Health (ODH), study analysis of Expanding Medicaid in Ohio, and our current data have lead us to several conclusions:

  • Currently there are over 20,000 uninsured residents of Miami County.
  • By 2022, there will still be an estimated 639,000 uninsured Ohioans even with the full expansion of Medicaid.
  • Eight percent of Ohio residents that qualify for the Health Insurance Exchange (HIX) will remain uninsured every year due to the inability to afford premiums or for other reasons.
  • The patient load increase of newly insured consumers will produce shortages of care in the already over-worked health care system.
  • At best, there will still be an estimated 5,000-10,000 uninsured residents of Miami County every year even after ACA is in full effect in 2022.

Here at Health Partners, we have never believed in letting grass grow under our feet.  In order to prepare ourselves for the unknown and unknowable healthcare challenges that will come over the next 3 to 5 years with ACA implementation in the Miami County, Health Partners has taken proactive steps to meet the needs of the community head on.  These steps include an expansion in available primary care provider hours to care for the estimated 5,000 residents whom will remain uninsured after ACA implementation, as well as, placement of a Marketplace Navigator in the Clinic whom will serve the County by providing a guided tour of the Healthcare.gov website.  This Navigator is an invaluable resource given to us through and managed by the Ohio Association of Free Clinics.

A noted French author once said, “The only thing constant in life is change.”  I couldn’t agree more.  Many changes are coming for healthcare in this country, and not many people seem to have much insight on those changes.  As for Health Partners, we plan to be here at the Paul G. Duke Health Center, serving those in need.