America’s Free and Charitable Clinics: Vital Support for 30 Million Uninsured Americans
Publication released August 2014 from the National Association of Free and Charitable Clinics

The Affordable Care Act and the Future of the Free Clinic

On March 23, 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA), into law. This has led to changes and adjustments throughout the world of health care, and lots of questions, too. If you have wondered how the Free Clinic’s mission and services might be impacted by the Affordable Care Act, here are some answers to frequently asked questions.

Q: Now that everybody has insurance, what will happen to the Free Clinic? Who will the Free Clinic serve?
A: Not everyone has, or will have, insurance. The Free Clinic will serve the uninsured and underinsured who are unable to access urgent care. Before the ACA, there were 60,000 uninsured people in Clark County. It is estimated there will be 30,000 uninsured by 2016.  Also, it is not clear if there are enough providers in Clark County to serve the people who are newly enrolled in Medicaid and Medicare. It is anticipated there will be a number of people who cannot afford their deductibles and co-pays. When they need urgent care, they may need the Free Clinic. It is important to note: insurance does not equal access.

Q: How has the ACA affected the Free Clinic? Has the number of patients decreased?
A: Patient visits at the Free Clinic are down about 35%. There will continue to be people who need the Free Clinic because they cannot obtain care any other way in our community.

Q:  Will the Free Clinic start accepting insurance from patients?
A: No.

Q:  If a patient has Medicaid, can he/she still come to the Free Clinic for primary care?
A: We do not provide ongoing care. We encourage people to find a provider and a primary care home. The Free Clinic will accept people who come for urgent needs and have not been able to access care anywhere else.

Q:  What if a patient chooses not to take insurance; can that patient use the Free Clinic?
A: Yes, but only for urgent care; not ongoing care. And the patient must meet income requirements of the Free Clinic.

Q:  Will the Free Clinic still need volunteers?
A: Yes! Without volunteers, there would be no Free Clinic. They are fulfilling a great need in our community.

Q:  Won’t the number of non-English-speaking patients increase? How will the Free Clinic assist them?
A: As our patient population changes, we will adapt. If necessary, we will actively recruit volunteers as interpreters.

Q: What services/programs at the Free Clinic will continue, and will there be new programs?
A: The Free Clinic will continue to provide urgent medical and dental care, medication assistance, preventive dental services for children, vision care, children’s immunizations, health screenings, sports physicals, and short-term diabetes care. The Free Clinic will also continue to coordinate specialty and oral health services in the community for Free Clinic patients. We are committed to adjusting our programs and services to align with the Free Clinic’s mission and vision.

Q:  Will the Free Clinic funding needs change?
A: It is still too early to tell whether the Free Clinic’s funding needs will change. As patient visits and services change, we will make appropriate adjustments in expenses. We will continue to rely on the monetary support of local individuals, businesses and organizations, and grants to keep us running. We will always invest gifts from our donors wisely.

Q: What services are covered under the Affordable Care Act?
A: The ACA requires health plans encompass what are called Essential Health Benefits. These must include services within the following 10 categories: ambulatory patient services; emergency services; hospitalization’ maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services. In the State of Washington, oral health (dental) and vision care are provided for Medicaid patients.

If you have other questions about the Affordable Care Act and its impact on the Free Clinic, please email us.